Electronic Theses and Dissertations

Identifier

6726

Date

2021

Date of Award

7-12-2021

Document Type

Dissertation

Degree Name

Doctor of Philosophy

Major

Social and Behavioral Sciences

Committee Chair

Satish K Kedia

Committee Member

Kenneth D Ward

Committee Member

Latrice C Pichon

Committee Member

Xinhua Yu

Abstract

Adolescent e-cigarette use has reached an epidemic level in the United States (US). It is therefore critical to encourage adolescents to quit e-cigarettes. The present research draws upon the Stages of Change (SOC) of the Trans-theoretical Model (TTM) and the Socio-Ecological Model to examine: 1) the association of socio-ecological factors with the SOC for intention to quit e-cigarettes among US adolescents; 2) the transitions across stages of e-cigarette quitting and its association with socio-ecological factors; and 3) the association of socio-ecological factors among US adolescents who quit using e-cigarettes (quitters) vs. those who did not quit (non-quitters). We conducted one cross-sectional (n=349) and two prospective observational studies (n=243 and n=177) using data from past 30-day adolescent exclusive e-cigarette users participating in Wave 3 and/or Wave 4 of the Population Assessment of Tobacco and Health (PATH) survey. Data analyses were performed using weighted unadjusted and/or adjusted multivariate and multinomial logistic regression analysis, and structural equation modeling (SEM). At the individual level, we found that adolescents who perceived that people cause a “lot of harm” to themselves relative to “no harm” when they use e-cigarettes were approximately 11 times more likely to be in the preparation stage than pre-contemplation stage. Furthermore, adolescents were significantly less likely to quit e-cigarettes if they perceived that people harm themselves “a little/some” from e-cigarettes and nicotine in e-cigarettes was “slightly/somewhat harmful” to health. At the interpersonal level, those adolescents who reported that important people in their life used e-cigarettes were significantly less likely to transition from pre-contemplation to action stage and 6.8 times more likely to remain stagnant in the pre-contemplation stage. At the environmental/policy level factors, adolescents who “often/very often” and “rarely/sometimes” noticed health warnings on e-cigarette packages relative to those who “never” noticed such warnings were approximately 4.7 times and 3.2 times, respectively, more likely to be in the contemplation stage than pre-contemplation stage. The SEM findings showed direct significant relationship of individual (b =0.206, p = 0.02) and interpersonal factors (b = 0.170, p = 0.04) with e-cigarette quitting behavior. Multi-level interventions are needed to encourage adolescents to positively navigate through stages of quitting e-cigarettes, and eventually help them to quit using these products.

Comments

Data is provided by the student.

Library Comment

dissertation or thesis originally submitted to the local University of Memphis Electronic Theses & dissertation (ETD) Repository.

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