1. descriptive e-cigarette norms on tobacco attitudes and smoking behavior: The importance of close friends and peers Michael Coleman & William D. Crano

2. Overview Background E-cigs vs. Tobacco Current Study Methodology
Results
Discussion

3. Background E-cigs: Handheld battery-operated nicotine delivery devices
Presented as the solution to traditional cigarettes
Manufacturers claim they are harmless (Water vapor) & help smokers quit
Recent research suggests that E-cigs may attract young smokers
(Bullen et al., 2010; Eissenberg, 2010; Vansickel et al., 2010)

4. E-cigs Vs. Traditional Cigs: Examining the Link
Current E-cig use Among Middle and High school Students from
Ever-use rates in School Children:
Middle 4.5%
High: 5% - 38%
Decline in Cigarette Use
Middle: 4.3% - 2.2%
High: 15.8% - 8%
Latest Research Suggests that E-cigs May Serve to Attract Young Smokers to Tobacco Use
Exposure to Nicotine and Normalization of Smoking Behavior May be Contributing Factors to Later Cigarette and Marijuana Use
Adolescents May be Especially Susceptible to Nicotine Addiction Due to Developmental Period
Preliminary Evidence Suggests Drop in Cigarette Use, but NOT Overall Tobacco Use
However Previous Research has not Examined the Importance of Normative Influence and has Relied on Cross-Sectional Data
(Kandel, Yamagucho, & Chen, 1992; Camenga et al., 2014; Bunnel et al., 2015)

5. The Current Study
Longitudinal Data Collected from Alternative High-School Students in Southern California
Hypotheses:
H1- Non-tobacco smoking participants with peers or parents reporting e-cig use will report higher willingness to try regular cigarettes.
H2- Non-tobacco smoking participants who consider e-cigs normative (>50% peer use) will report higher willingness to try regular cigarettes.
H3- Peer and Family use of E-cigs will be associated with more positive expectancies towards regular cigarettes.
H4- Non-tobacco smoking participants with Peers and Family reporting E-cig use will report higher rates of traditional tobacco use one year post.
H5- Non-smoking (Tob/MJ) participants with Peers and Family reporting E-cig use will report higher rates of traditional tobacco and marijuana use one year post.

6. Method
Secondary Data Analysis
Data Obtained from CGU School of Community and Global Health
Longitudinal Study Focused on E-cigarettes, Traditional Tobacco Use and Marijuana Use
Total Dataset Included 2,727 Alternative High-School (AHS) students
Present Study Focused on Adolescents (Ages 15-18) N = 788 (Mean Age: 17, SD = 1.09)

7. Measures Tobacco Use Willingness (Gerrard et al., 2008)
Family & Peer Smoking (Youth Tobacco Survey, 2014)
Peer & Family Ever Use E-cigs
Four Closest Friends E-cig Use
Tobacco Use Willingness (Gerrard et al., 2008)
“If it were offered by one of your friends, how willing would you be to try…?”
E-cig/Tobacco/Marijuana Use Use (Youth Tobacco Survey, 2014)
“Have you ever used…?”
Positive Tobacco Expectancies (Youth Tobacco Survey, 2014)
“Smoking is enjoyable”
“Smoking leaves a pleasant tingle on the tongue”

8. Results
H1: “Non-tobacco smoking participants with peers or parents reporting e-cig use will report higher willingness to try regular cigarettes.”
Independent Samples T-Tests:
Participants reporting close friend e-cig use reported higher willingness to accept cigarettes.
t(397) = 3.36, p < .001.
Binary Logistic Regression:
No Significant Relationship of Gender or Age
Hispanic Youth: greater odds
At least 1 Peer using E-cigs: 4.46 greater odds
Parent Use: 1.47 greater odds

9. Results Cont.
H2: “Non-tobacco smoking participants that consider e-cigs normative (>50% peer use) will report higher willingness to try regular cigarettes.”
Independent Samples T-Tests:
Participants reporting e-cig use as normative reported higher willingness to accept cigarettes.
t(403) = 2.89, p < .001.
Binary Logistic Regression:
No Significant Relationship of Gender or Age
Hispanic Youth: greater odds
Normative E-cig Use: 3.11 greater odds

10. Results Cont.
H3: “Peer and Family use of E-cigs will be associated with more positive expectancies towards regular cigarettes.”
Two One-way ANCOVAs were conducted to examine if adolescents reporting close friend or parent e-cig use would report more positive expectancies towards regular cigarettes
Results Indicated Significant Effect of Peer E-cig Use on Positive Expectancies after controlling for sample characteristics
F(1,495) = 16.24, p < .001
Significant Effect of Family Member E-cig use on Positive Expectancies F(1, 440) = 5.73, p < .01

11. Results
H4: “Non-tobacco smoking participants with Peers and Family reporting E-cig use will report higher rates of traditional tobacco use one year post.”
Path analysis based on structural equation modeling (Crano, Brewer, & Lac, 2015)
Model:
χ2 (2) = 2.36
p = .31
CFI = .99
TLI = .99
RMSEA = .02
90%CI = ( )
R2 = .58

12. Results
H5: “Non-smoking (Tob/MJ) participants with Peers and Family reporting E-cig use will report higher rates of traditional tobacco and marijuana use one year past.”
Path analysis based on structural equation modeling
Model:
χ2 (2) = 2.16
p = .27
CFI = .98
TLI = .97
RMSEA = .03
90%CI = ( )
R2 = .55

13. Discussion
Present data supports the link between E-cig use and normative beliefs about e-cigs to traditional cigarette and marijuana use. 1
Peer norms and prior use have the strongest impact on tobacco expectations, willingness to try, and future tobacco and marijuana use. 2
Path model analysis provides new longitudinal evidence for the relationship of e-cigs to the onset of tobacco and marijuana use. 3

14. Limitations & Future Directions
Study Sample: Limited, but Important
Secondary Analysis
Choice of measures limited, but good
Other?
There always are other issues

15. Conclusion Tobacco/Marijuana Norms E-Cig Use
Set out to Examine the Relationship of E-cig Norms and Traditional Tobacco/Marijuana Use.
Present Study Found Support for all Hypotheses.
Future Research Should Examine the Potential Pathways of Multiple Norms Measures on E- cig and Traditional Cigarette/Marijuana Use .