Although Electronic Nicotine Delivery Systems (ENDS) are being increasingly used among young adults, little is known about the predictors of ENDS initiation. A new study examined the roles of the social environment, including peer ENDS use and household ENDS use, normative beliefs, including social acceptability of ENDS use, and attitudes, including inclination to date someone who uses ENDS, in prospectively predicting the initiation of ENDS over a one year period. Participants (N = 2,110) were students from 24 colleges in Texas, between the ages of 18 to 29. Participants included were those who indicated never using ENDS at baseline. They completed a three-wave online survey, with 6 months between each wave, from which the following information was obtained. Ever ENDS use, initiation of ENDS, peer ENDS use, household ENDS use and social acceptability of ENDS use were all assessed using items adapted from the Population Assessment of Tobacco and Health (PATH) study by the NIH. Inclination to date someone who uses ENDS was assessed using an item adapted from the Monitoring the Future study by the NIDA. The authors used unadjusted multilevel logistic regression models were used to examine bivariate associations between the four social environment, normative beliefs, and attitudes variables at baseline and subsequent initiation of ENDS across the 1-year period. In addition, a multivariable, multilevel logistic regression model was used to assess the unique associations between the four baseline variables and subsequent ENDS initiation, after accounting for the covariates. Results showed that after 1 year, 15.6% (n = 329) of college students, who were never users of ENDS at baseline, indicated initiating ENDS. Furthermore, chi-square analyses examining baseline socio-demographic characteristics indicated that males and Hispanics/ Latinos were significantly more likely and Asians were significantly less likely than their counterparts to initiate ENDS. Moreover, younger college students, 18 to 24 years old, and those reporting a greater number of other tobacco products ever used had greater odds of reporting subsequent initiation compared with their peers. Lastly, among the social environment, normative beliefs, and attitude variables, only peer ENDS use (p < .05) and inclination to date someone who uses ENDS (p < .05) uniquely predicted increased odds of subsequent ENDS initiation, after accounting for all covariates.
Take away: College students who had higher odds of initiating ENDS than their peers were younger, used other tobacco products in the past, had a more dense peer network of ENDS users, and had a higher inclination to date someone who uses ENDS.