Date of Award

2019

Document Type

Dissertation

Degree Name

Doctor of Health Administration

College

College of Health Professions

First Advisor

Daniel L. Brinton

Second Advisor

Annie N. Simpson

Third Advisor

Leah M. Ranney

Abstract

Low SES is associated with tobacco use among adolescents in the United States. Few studies have looked at the associations between SES and initiation of e-cigarette use by adolescents. This study aims to clarify the associations among SES, e-cigarette use uptake and potential mediating factors in a national sample of adolescents. The study population includes adolescents aged 12-17 years who participated in the Population Assessment of Tobacco and Health (PATH) study from 2013-2016. Logistic regression and mediation model analysis were used to analyze the data. The study found that older adolescents (ages 14-16) had consistently higher odds of ever e-cigarette use compared to 13 year olds. Adolescents who reported having ever used alcohol, marijuana, abused prescription drugs or had prior tobacco use were more likely to initiate e-cigarettes than those who had not used these products. High income was associated with higher odds of e-cigarette initiation than middle income. Parental tobacco use and advertising exposure have a mediating effect on the association between SES (income) and initiation of e-cigarette use among adolescents. Findings support the need for stronger regulations to reduce advertising and marketing to adolescents. Interventions aimed at high income adolescents would be beneficial.

Rights

All rights reserved. Copyright is held by the author.

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