Wills Thomas A, Gibbons Frederick X, Sargent James D, Schweitzer Rebecca J
Prevention and Control Program, University of Hawaii Cancer Center.
Center for Health, Intervention and Prevention, University of Connecticut.
Psychol Addict Behav. 2016 Dec;30(8):876-886. doi: 10.1037/adb0000213. Epub 2016 Sep 26.
E-cigarette use by adolescents has been related to onset of cigarette smoking but there is little knowledge about the process(es) through which this occurs. Accordingly, we tested the role of cognitive and social factors for mediating the relation between e-cigarette use and smoking onset. A school-based survey was conducted with a baseline sample of 2,338 students in Hawaii (9th and 10th graders, mean age 14.7 years) who were surveyed in 2013 (Time 1, T1) and followed up 1 year later (Time 2, T2). We assessed e-cigarette use, cigarette smoking, demographic covariates, and 4 hypothesized mediators: smoking-related expectancies, prototypes, and peer affiliations as well as marijuana use. The primary structural modeling analysis, based on initial never-smokers, used an autoregressive model (entering T2 mediator values adjusted for T1 values) to test for mediational pathways in the relation between e-cigarette use at T1 and cigarette smoking status at T2. Results showed that e-cigarette use was related to all of the mediators. Tests of indirect effects indicated that changes in expectancies, affiliations, and marijuana use were significant pathways in the relation between e-cigarette use and smoking onset. A direct effect from e-cigarette use to smoking onset was nonsignificant. Findings were replicated across autoregressive and prospective models. We conclude that the relation between adolescent e-cigarette use and smoking onset is in part attributable to cognitive and social processes that follow from e-cigarette use. Further research is needed to understand the relative role of nicotine and psychosocial factors in smoking onset. (PsycINFO Database Record
青少年使用电子烟与开始吸烟有关,但对于这一过程的发生机制却知之甚少。因此,我们测试了认知和社会因素在介导电子烟使用与开始吸烟之间关系中的作用。对夏威夷2338名学生(9年级和10年级,平均年龄14.7岁)进行了一项基于学校的调查,这些学生于2013年接受了基线调查(时间1,T1),并在1年后进行了随访(时间2,T2)。我们评估了电子烟使用、吸烟情况、人口统计学协变量以及4个假设的中介因素:与吸烟相关的预期、原型、同伴关系以及大麻使用情况。主要的结构模型分析基于最初从不吸烟的人群,使用自回归模型(输入根据T1值调整后的T2中介变量值)来测试T1时电子烟使用与T2时吸烟状况之间关系的中介路径。结果表明,电子烟使用与所有中介因素都有关。间接效应检验表明,预期、同伴关系和大麻使用情况的变化是电子烟使用与开始吸烟之间关系的重要路径。电子烟使用对开始吸烟的直接效应不显著。研究结果在自回归模型和前瞻性模型中都得到了重复验证。我们得出结论,青少年电子烟使用与开始吸烟之间的关系部分归因于电子烟使用后的认知和社会过程。需要进一步研究以了解尼古丁和心理社会因素在开始吸烟中的相对作用。(PsycINFO数据库记录)