Perceived Norms and Vaping Among Young Adults in College: The Mediation Role of Expectancies

Background and Purpose: Although vaping has been promoted as a safer alternative to combustible cigarettes, there is evidence indicating that vaping is associated with increased risks of lung infections and asthma. Perceived norms and expectancies have been found to directly predict young adult vaping. However, little is known about the mechanisms through which perceived norms influence vaping. Guided by the revised theory of planned behavior (Kuther, 2002), we hypothesized that expectancies would explain the relationship between perceived norms and daily vaping episodes; thus, this study examined the mediating roles of vaping expectancies on the impacts of perceived norms on daily vaping episodes.

Method: A confidential online survey on young adults’ vaping network was given to 616 college students at a large Hispanic-serving public university in the southwestern United States (M_age = 20.49, SD = 1.48; 82.0% women; 83.4% white). Participants who (1) were aged 18 to 25 years and (2) had ever used e-cigarettes containing nicotine were eligible for this study. Online informed consent was obtained from all participants, and the study protocol was approved by the Institutional Review Board (IRB). Perceived norms (i.e., descriptive and injunctive norms) and daily e-cigarette use episodes were each measured with a single item. E-cigarette expectancies were measured with the 21-item short form vaping consequences questionnaire (Meghan et al., 2017), which is a four-dimensional scale (i.e., positive reinforcement, negative reinforcement, negative consequences, and weight or appetite control). Path analysis was conducted in Mplus using full information maximum likelihood estimation.

Results: The results showed that only positive reinforcement expectancies partially mediated the association between descriptive norms and daily e-cigarette use frequency. Thus, descriptive norms have a positive indirect effect on daily vaping episodes through positive reinforcement expectancies (b = 0.02, p = .029, 95% CI [0.00, 0.04]). The total effect indicated that daily vaping episodes were positively associated with descriptive norms (b = 0.50, p < .001, 95% CI [0.39, 0.62]) and injunctive norms (b = 0.29, p < .001, 95% CI [0.20, 0.46]). In addition, descriptive norms (IRR = 1.60, 95% CI [0.36, 0.58], p < .001) and injunctive norms (IRR = 1.36, 95% CI [0.19, 0.43], p < .001) were directly associated with daily vaping episodes.

Conclusions and implications: The findings highlighted that positive reinforcement vaping expectancies, such as the enjoyment of the flavor of e-cigarettes, play a key role in explaining how descriptive norms (i.e., perceptions of how common e-cigarette use is among peers) influence e-cigarette use among college students. This finding has several important implications for public health, policy, and intervention strategies aimed at reducing e-cigarette use among young adults. Future interventions or educational programs can focus on changing social perceptions and clarifying the long-term health risks associated with vaping, such as the potential for addiction and lung damage, which will help college students make more informed decisions.