Purpose

This study sought to evaluate whether associations between adolescent combustible cigarette smoking and e-cigarette progression were explained by beliefs that e-cigarettes substitute for cigarettes in nonsmoking situations.

Methods

Adolescents (N = 1,799) from public high schools outside of Philadelphia, PA, completed in-classroom surveys at wave 1 (fall 2016, beginning of ninth grade) and at 6-month intervals for the following 36 months (fall 2019, beginning of 12th grade).

Results

A parallel process latent growth curve model revealed that the pathway from baseline smoking to e-cigarette use trend through baseline e-cigarette substitution beliefs was significant (B = .02, z = 2.16, p = .03), indicating that the positive effect of greater baseline cigarette smoking on the rate of e-cigarette progression was channeled through e-cigarette substitution beliefs. The indirect effect from baseline smoking to e-cigarette use trend via e-cigarette substitution beliefs trend was also significant, albeit negative (B = -.05, z = -2.61, p = .009). The negative indirect effect suggested that the strong positive effect of baseline cigarette smoking on baseline substitution beliefs was followed by a slowing of the overall rate of change from baseline. Given that the total effect from baseline smoking to e-cigarette trend was not significant (p = .91), the results suggested complete mediation.

Conclusions

Among adolescents with greater use of combustible cigarettes, beliefs regarding the substitutability of e-cigarettes in nonsmoking situations appear to foster progression in e-cigarette use. Addressing these beliefs in the school setting and through media campaign messaging early in adolescence may help to prevent the use of e-cigarettes and combustible cigarettes.

中文翻译：

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吸烟通过替代信念对电子烟发展的间接影响

 目的

本研究旨在评估青少年吸烟与电子烟进展之间的关联是否可以通过电子烟在非吸烟情况下替代香烟的信念来解释。

 方法

来自宾夕法尼亚州费城以外公立高中的青少年 (N = 1,799) 在第一波（2016 年秋季，九年级开始）完成了课堂调查，并在接下来的 36 个月（2019 年秋季，九年级开始）中每隔 6 个月完成了一次课堂调查。 12 年级）。

 结果

并行过程潜在增长曲线模型显示，通过基线电子烟替代信念从基线吸烟到电子烟使用趋势的路径是显着的（B = .02，z = 2.16， p = .03），表明积极影响基线吸烟对电子烟进展率的影响是通过电子烟替代信念来实现的。基线吸烟通过电子烟替代信念趋势对电子烟使用趋势的间接影响也很显着，尽管是负面的（B = -.05，z = -2.61， p = .009）。负面的间接效应表明，基线吸烟对基线替代信念产生强烈的积极影响之后，总体变化率相对于基线的变化速度减慢。鉴于基线吸烟对电子烟趋势的总影响并不显着 ( p = .91)，结果表明完全中介。

 结论

在更多使用可燃香烟的青少年中，关于电子烟在非吸烟情况下的替代性的信念似乎促进了电子烟使用的进展。在学校环境中并通过青春期早期的媒体宣传宣传来解决这些信念可能有助于防止电子烟和可燃香烟的使用。