Examining social norm beliefs about traditional cigarettes and electronic cigarettes among U.S. sexual minority college students

Date

2019-05-13

Authors

Skinner, Darrien Adam James

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Abstract

Objective: Sexual Minority (SM) young adults, 18 – 24 year olds who identify their sexuality as anything other than heterosexual, are one minority that is well documented to have higher tobacco use rates than heterosexual young adults. However, very little research examines the social norm beliefs associated with smoking cigarettes or vaping electronic nicotine delivery systems (ENDS; commonly referred to as e-cigarettes, JUULs, vape pens, etc.), held by the SM college age population compared to heterosexual peers. The purpose of the present study was to determine if 1) SM young adults have more favorable social norms about cigarette and ENDS use than heterosexual peers and 2) if social norms account for, or potentially mediate, the disparity in cigarette and ENDS use in SM young adults. More accepting injunctive and descriptive social norms were each hypothesized to explain, or mediate, the association between SM identity and subsequent cigarette or ENDS use. Methods: In spring 2018, online surveys were administered via email to college students at seventeen public universities in Texas; 10,213 18-24 year old young adults (M age = 20.4; 64.6% female sex assigned at birth; 48.3% Hispanic, 27.5% non-Hispanic White, 7.2% non- Hispanic Black, 12.7% non-Hispanic Asian, and 4.2% other race/ethnicity) met criteria to be included in this study. Surveys assessed current/past-30 day tobacco use behavior (cigarettes and ENDS), SM identity, injunctive normative perceptions of tobacco use (perceived acceptability of behavior), and descriptive normative perceptions of tobacco use (perceived peer behavior). Path analysis was used to determine if the potential association between SM status and current cigarette or ENDS use is mediated by social norm perceptions (injunctive norms and descriptive norms) about cigarette or ENDS use. Separate models were examined for current cigarette use and for current ENDS use. Results: SM young adults reported higher prevalence of cigarette and ENDS use, and more accepting injunctive norm beliefs about cigarette or ENDS use than their heterosexual peers. There were no differences between the two groups on descriptive norm beliefs. Results from path analyses indicated that only injunctive norm beliefs about cigarette or ENDS use significantly mediated the associations between SM identity and current cigarette or ENDS use, respectively, while controlling for age, sex, race and other tobacco product use. Descriptive norm beliefs were significantly associated with current cigarette or ENDS use, but SM status was not associated with descriptive norm beliefs. Conclusion: Findings from this study suggest that it is important to address tobacco use among the SM young adult population. Tobacco prevention and control initiatives should focus efforts on changing injunctive norm beliefs, or perceived peer acceptability of cigarettes or ENDS, about tobacco use in the community of SM young adults instead of allocating more resources to address descriptive norm beliefs, or prevalence of peer use of cigarettes or ENDS

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