Where college students look for vaping information and what information they believe.

Objective: This convergent mixed methods study examined how information sources influence college students' beliefs and knowledge about vaping. Participants: College students either completed a survey (n = 522; January-April, 2016) or were interviewed (n = 33; 2015-2016). Methods: College students completed an online survey asking 'where' students had heard about e-cigarette and 'what' they had heard. Responses were quantified and a chi-square analysis was conducted. Additional college student e-cigarette users were interviewed about the credibility of information sources. Thematic analysis was conducted with the coded interviews. Results: There was a significant relationship between information sources for e-cigarettes (social sources, media, advertising, education/research) and the messages they recalled. Friends who vaped and e-cigarette users were the most credible information sources. Confirmation bias and scientific impotence bias characterized assessment of e-cigarette information. Conclusions: Health education specialists working on college campuses should provide accurate information via communication channels most unitized by college students.

Using the Ecological Model to understand influences on college student vaping.

Objective The Ecological Model was used to examine the social and environmental influences of the college environment on e-cigarette use (vaping) among college students. PARTICIPANTS: Undergraduate college student e-cigarette users (vapers) across three large college campuses in the southwest US from Jan 2015- Aug 2016. METHODS: Thirty-three interviews were conducted. Transcribed interviews were coded then analyzed for themes. RESULTS: College student vapers report multiple levels of influence on their vaping beyond personal beliefs and peer influences, including parents, explicit campus and community messaging, community member requests, and respect for others. College student vapers also describe constant associations with smokers in allowable public places to vape. CONCLUSIONS: Parents, community members, campus policy, and the physical environment all influence where and when college students vape. Health communication messages to prevent college student vaping should incorporate alternative messages that are important to college students, such as respect for others and social image.

Knowledge and Beliefs About E-Cigarettes in Straight-to-Work Young Adults.

INTRODUCTION: Young adults are a growing segment of electronic cigarette (e-cigarette) users. Young adults who go straight to work (STW) from high school make up a large portion of the young adult population, yet research to date has focused on college-educated young adults. This study explored STW young adult beliefs and knowledge about e-cigarettes. METHODS: Semistructured individual interviews were used to elicit in-depth information from STW young adults ages 19-31 from a state in the southwest United States. Thirty interviews were conducted focusing on beliefs about e-cigarettes, current knowledge, and information-seeking practices. Interviews were recorded, transcribed, and analyzed using NVivo. RESULTS: Nine themes were identified falling into three categories: (1) beliefs about e-cigarettes, (2) knowledge about e-cigarettes, and (3) personal rules about e-cigarettes. STW young adults held positive beliefs about the health and safety of e-cigarettes for themselves, others, and the environment. They reported their social networks and the Internet as reliable sources of information about e-cigarettes, but they reported parents as the best source for advice. Participants had rules about e-cigarettes that contradicted some of their beliefs such as using e-cigarettes around children indicating that their beliefs were not as strongly held as they initially reported. CONCLUSIONS: Industry marketing and contradictory information may contribute to STW young adult knowledge and beliefs about e-cigarettes. Lack of credible public health information may also contribute to this issue. Ensuring that what is known about the benefits and harms of e-cigarettes is conveyed through multichannel communication and continued monitoring of marketing practices of the e-cigarette industry in light of the soon to be implemented regulations should be top priorities for public health. IMPLICATIONS: Beliefs and knowledge of STW young adults have not been explored even though they are heavily targeted by the e-cigarette industry. This group holds strong positive beliefs about the health and safety of e-cigarettes, despite having little credible knowledge about them. This study indicates a need for efforts focused on educating STW young adults on the potential risks and benefits of e-cigarettes and the communication of credible information or at minimum the acknowledgment of the uncertainty regarding the long-term health effects of e-cigarettes. It also indicates a need for continued monitoring and advocacy related to marketing practices of the e-cigarette industry.

Electronic Cigarette Use in Straight-to-Work Young Adults.

OBJECTIVE: We explored beliefs about electronic cigarettes (e-cigarettes) as well as social influences on e-cigarette use in straight-to-work (STW) young adults. METHODS: Thirty interviews were conducted with STW young adults ages 19-31 years old. We asked participants about smoking and e-cigarette use, beliefs about e-cigarettes, and influences on decisions to use e-cigarettes. We conducted interviews in community locations and transcribed and coded them using NVivo. RESULTS: We identified 4 themes: benefits of e-cigarette use; dual use/continued smoking; social influences; and quitting smoking and e-cigarettes. STW young adults initiated e-cigarette use to quit smoking but most became dual users or reported cycles of smoking and e-cigarette use. Flavors were a primary attraction for e-cigarette users. Family and friends supported e-cigarette use and often provided participants with their first e-cigarette. Most participants who no longer identified as smokers still smoked occasionally. Users felt they were more positively perceived by others when they used e-cigarettes but were still seen as smokers or former smokers. CONCLUSIONS: E-cigarette use may bring STW young adults closer to their aspirational identity of non-smoker but many may be vulnerable to smoking relapse or increased dependence on nicotine through dual use.

Vapor Store Owner Beliefs and Messages to Customers.

INTRODUCTION: Electronic cigarette (e-cigarette) use is becoming increasingly popular but little is known about the role of the local vapor store in promoting use and influencing customer attitudes and beliefs about vaping. METHODS: Thirty-three vapor store owners were interviewed about their personal beliefs and attitudes about e-cigarettes and what they told customers about the health impact of using e-cigarettes. Interviews were recorded then transcribed, coded, and analyzed for themes. RESULTS: Vapor store owners used the internet to obtain information about vaping, most often from YouTube and industry sources. Owners often did not have the training to critically evaluate research studies posted on the internet. Owners promoted vaping as a healthier alternative to smoking and often compared it to a medical treatment. Owners considered ingredients in the e-liquid as safe to use if it was safe to eat and discussed other foods vapor ingredients were found in. Owners also discussed the safety of secondhand vapor. Owners described the health impact of nicotine in e-liquid by comparing nicotine to caffeine and promoted the nicotine in e-liquid as coming from vegetables rather than tobacco. Finally, owners talked about vaping as a habit rather than a continued addiction to nicotine. CONCLUSIONS: Local store owners are an important source of health information for current and potential e-cigarette users but their messages to customers may be based on incomplete or misinterpreted information. Understanding local store owner messages to customers in addition to internet-based messages is an important area for future public health research.

Marketing practices of vapor store owners.

OBJECTIVES: We examined the marketing strategies for local vapor stores in a large metropolitan area in Oklahoma. METHODS: Vapor store owners or managers (n = 33) participated in individual interviews regarding marketing practices in 2014. We asked owners about their marketing strategies and the groups they targeted. We transcribed the interviews and analyzed them for themes. RESULTS: Store owners used a variety of marketing strategies to bring new customers to their stores and keep current customers coming back. These marketing strategies showed many parallels to tobacco industry strategies. Most owners engaged in some form of traditional marketing practices (e.g., print media), but only a few used radio or television advertising because of budget constraints. Owners used social media and other forms of electronic communication, pricing discounts and specials, and loyalty programs. Owners also had booths at local events, sponsored community events, and hosted them in their stores. Owners attempted to target different groups of users, such as college students and long-term smokers. CONCLUSIONS: Local vapor store marketing practices closely resemble current and former tobacco industry marketing strategies. Surveillance of marketing practices should include local and Web-based strategies.

Smoking and membership in a fraternity or sorority: a systematic review of the literature.

OBJECTIVE: Fraternity and sorority members have higher rates of smoking than other college students. This systematic review examines studies that included fraternity/sorority membership in their investigation of smoking behaviors. PARTICIPANTS/METHODS: Studies identified in MEDLINE, PsychInfo, JSTOR, CINAHL, ERIC, and Google Scholar published between 2003 and 2013 were included if they included fraternity and/or sorority membership, were written in English, published in a peer-reviewed journal, and had smoking as an outcome variable. Nineteen studies were identified for the review. RESULTS: Fraternity/sorority members were more likely to be nondaily smokers. Members who lived in the fraternity/sorority house had higher rates of smoking than members who lived elsewhere. Fraternity/sorority member smoking was associated with alcohol and other substance use. The influence of no-smoking policies on fraternity/sorority member smoking was also examined. CONCLUSIONS: Fraternity/sorority membership was associated with higher rates of smoking, but this association was influenced by other substance use and environmental factors.