1. E-cigarette Use among College Students:
A Pilot Sample Scale Development using the Reasoned Action Approach
Dobbs, P. D. ¹²; Jozkowski, K. N. ²; Blunt, H. D. ²; Hammig, B. ²; Sudduth, A. ²
¹SUNY Cortland, Health Department
²University of Arkansas, Department of Health, Human Performance, & Recreation, Community Health Promotion Program
Introduction
Methods
Principal Component Analysis
Table 2: PCA from Pilot Sample 
Factor1
Factor2
Factor3
Factor4
Factor5
Factor6
Factor7
Factor8
Attitudes
Relieve stress
0.825
Feel more relaxed
0.759
Cause less harm to my body
0.736
Stay awake and alert
0.713
More harm to my body
-0.935
Cause damage to my lungs
-0.932
Experience unknown side effects of e-cigarettes
-0.893
Smell bad
-0.781
Experience a bad taste
-0.917
Injunctive Norms
People who already use e-cigarettes
0.679
Fraternity members
0.775
People trying to “fit in”
0.700
People at parties
0.878
My parents
0.924
My friends
0.877
My religious organization
0.741
My mentors
0.740
My significant other
0.915
Health officials
0.830
My employer/s and colleague/s
0.671
Health conscious people
Descriptive Norms
Most fraternity members
0.583
Most freshmen
0.852
Most people who regularly attend parties
0.845
Most people who drink
0.964
Most students who know others who use e-cigarettes
0.932
Most people who want to "fit in"
0.761
Most athletes
0.755
Most students who DO NOT drink alcohol
0.893
Most people who are confident
0.617
Most people who quit smoking cigarettes
0.853
PBC
Someone offering me samples of e-cigarettes
-0.806
E-cigarettes being cheap
Being around people who use e-cigarettes
-0.824
A friend offering their e-cigarette to me to try
Caring about what my family and friends think
0.785
Respecting myself
0.884
Not buying an e-cigarette
0.618
% Variance
19.99
16.42
12.01
10.14
7.15
6.74
5.47
3.72
Cronbach's α
0.95
0.93
0.96
0.91
0.89
0.783
0.84
0.88
Phase 1
Salient belief elicitation procedure (Middlestadt, 2006) was employed.
This procedure is especially important for new behaviors, such as e-cigarettes use.
Salient consequences, referents, and circumstance regarding e-cigarette use were elicited through an open-ended online survey.
These responses were grouped into themes and used to develop quantitative items employed during Phase 2.
Phase 2
A pilot sample (n = 44) was administered using a 206-item cross-sectional quantitative survey.
162 items assessed the salient RAA constructs (attitudes, perceived norms, perceived behavioral control). Each underlying construct (i.e., NB, MC) was measured on a bi-polar scale (-3 to +3).
The measures for the global constructs were calculated from the cross product of the underlying constructs (i.e., BB and EO were multiplied to give a score for attitude). A principal component analysis (PCA) was employed to determine factor loadings of the cross products.
Theory-based quantitative instruments assessing salient attitudes, norms, and circumstances influencing e-cigarettes do not exist. Trumbo and Harper (2013) first explored college students’ intention to use e-cigarettes using the Theory of Reasoned Action (TRA). Their findings suggested that attitudes, but not social norms, significantly influence young adults’ intention to use e-cigarettes. Since the conception of the TRA, it has evolved with the inclusion of new constructs and operational definitions, as seen below in Reason Action Approach (RAA) (Fishbein, 2008; Fishbein & Ajzen, 2010).
Health concerns of e-cigarettes among young adults:
Nicotine exposure to the cerebral cortex during development (England, Bunnell, Pechacek, Tong, & McAfee, 2015).
Diacetyl, has been known to cause “Popcorn Lung” (Allen et al., 2016).
Nicotine addition (Corey et al., 2013; Schneider & Diehl, 2016; Wills, Knight, Williams, Pagano, & Sargent, 2015).
With e-cigarette use among young adults on the rise, this study sought to develop and then examine the reliability and validity of a new measure assessing intention to use e-cigarettes among college students, utilizing the RAA. The purpose of this study was to
elicit college students’ salient consequences, referents, and circumstances associated with e-cigarette use in the next 30 day,
(2) develop a validated theory-based quantitative instrument using the RAA constructs.
Results
For the PCA, we anticipated that items would form four different factors (attitudes, injunctive norms, descriptive norms, and PBC). As seen in Table 1, the oblique solution instead fell onto eight factors. Of the original 81 cross products from Phase 1, 42 cross products were removed that did not load significantly, that cross-loaded strongly on more than one factor, or that loaded on a factor not predicted by the theory. Of the remaining 39 cross products, nine cross products fell onto the two factors that made up attitude (advantages, α=.78; disadvantages, α=.96), 12 cross products fell onto the two factors that made up injunctive norms (approving referents, α=.84; disapproving referents, α=.95), 11 cross products fell onto the two factors that made up descriptive norms (most likely to use, α=.93; least like to use, α=.89), and seven cross products fell onto the two factors that made up perceived behavioral control (facilitating factors, α=.91; inhibiting factors, α=.88).
Theory
Behavioral Beliefs (BB)
(Salient Consequences)
Evaluation of Consequences (EO)
Normative Beliefs (NB)
(Salient Referents)
Motivation to Comply (MC)
With Referents
Control Beliefs (CB)
(Salient Circumstances)
Perceived Power (PP) of Circumstances
Behavior
Intention (IN)
Attitude toward Act (AA)
Perceived Norm (PN)
(Injunctive & Descriptive)
Self-Efficacy (SE)
(PBC)
Other Factors
Individual
Personality
Mood
Values
Perceived risk
Past behavior
Social
Education
Age, Gender
Income
Religion
Race
Culture
Information
Knowledge
Media
Intervention
Skills and Abilities
Environmental Constraints
Discussion
Further Scale Development
The findings from this study provide preliminary evidence of reliability and validity of the newly developed, theory-based measure.
Further examination of differences between users and non-users to better explain differences in perceptions that may influence
Utilization of Scale
Preliminary findings suggest strong factor loadings.
Theory-based measures can be used to explore new public health issues.
Understanding the influence of the RAA constructs on intention to use e-cigarettes may help prevention programs, policies, and social marketing to more effectively address key constructs that can prevent young adults from becoming addicted to nicotine.
Reasoned Action Approach (Fishbein, 2008; Fishbein & Ajzen, 2010)