Influence of Risk Perception on Attitudes and Norms Regarding Electronic Cigarettes.

The use of electronic cigarettes has grown substantially over the last few years. Currently, about 4% of adults use electronic cigarettes, about 16% of high school students report use in the past 30 days, as do approximately 11-25% of college students. A hallmark of the reduction in tobacco use has been the shift in social norms concerning smoking in public. Such norms may also drive views on acceptability of public electronic cigarette use. While normative factors have been given attention, little substantive application of the literature on risk perception has been brought to bear. The overall aim of this study was to place a cognitive-affective measure of risk perception within a model that also includes social cues for e-cigarettes, addictiveness beliefs, and tobacco use to predict perceived social acceptability for public use of e-cigarettes. To do so, a cross-sectional study using an online survey was conducted among a sample of undergraduate students at a Western university (n = 395). A structural equation model showed that the acceptability of public e-cigarette use was influenced by social cues, beliefs about addiction, and cognitive risk perception, even after controlling for nicotine use. What is revealed is that cognitive assessment of e-cigarette risk and perception of addictiveness had a suppressing effect on perceived acceptability of public vaping, while greater exposure to social cues exerted a countervailing effect. This is evidence of the role that risk perception and social norms may play in the increases in electronic cigarette use that have been observed.