Association Between E-cigarette Exposure and Susceptibility: the Mediation Effect of Perception

This study aims to explore the relationship between e-cigarette social environment exposure, perceptions, and susceptibility. We surveyed 4290 middle school students aged 13-18 in Shanghai, China. A multivariate logistic regression was performed to assess the correlation of e-cigarette social environment exposure, perceptions, and susceptibility in adolescents. A structural equation model was performed to explore the mediation effects of perception. It was found that there was a high rate of social environment exposure to e-cigarettes among adolescents in Shanghai, China. The exposure rate of e-cigarette secondhand aerosol, e-cigarette sales, and e-cigarette information was 42.1%, 69.1%, and 82.3%, respectively. E-cigarette social environment exposure could not only directly affect e-cigarette susceptibility, but also played a role through the mediation effect of perceptions, which accounted for 37.48%. E-cigarette exposure had a greater impact on benefit perceptions than harm perceptions. The influence of various types of e-cigarette exposure and perceptions on susceptibility was different. Among the exposure factors, the risk of secondhand aerosol exposure was the highest (OR = 1.56, 95% CI: 1.16-2.11). Among the perceptual factors, the risk of self-benefit perception was the highest (OR = 4.06, 95% CI: 2.91-5.68), and the risk of socio-environmental benefit perception was the lowest (OR = 1.85, 95% CI: 1.40-2.45). Hence, it is necessary to supervise exposure to e-cigarettes more strictly and strengthen the education of adolescents on e-cigarette cognition.

Automated summary

This study examines the relationship between e-cigarette social environment exposure, perceptions, and susceptibility. The findings reveal a high rate of social environment exposure to e-cigarettes among adolescents in Shanghai, China. The study also demonstrates that e-cigarette exposure not only directly influences susceptibility but also acts through the mediation effect of perceptions.