Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2025
Trends in Social Norms Toward Cigarette Smoking and E-cigarette Use Among U.S. Youth Between 2015 and 2021.
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Vu Giang T, Sun Tianze, Hall Wayne, Connor Jason P, Thai Phong, Gartner Coral, Leung Janni, Chan Gary
Аннотация
INTRODUCTION: This study examines trends in social norms toward cigarette smoking and e-cigarette use among US youth during 2015-2021, focusing on descriptive interpersonal norms (friends' behavior) and injunctive norms at interpersonal (perceived important others' negative view) and societal level (perceived public disapproval).
METHODS: Respondents were youth aged 12 to 17 from the Population Assessment of Tobacco and Health Study of the United States, Wave 3 (2015-2016) to Wave 6 (2021). Logistic regression models that adjusted for demographics and participation effects assessed norm changes over time and their association with use status in Wave 6.
RESULTS: Between 2015 and 2021, the probability of having friends who smoked cigarettes decreased (26.1% vs. 7.9%, adjusted odds ratio [aOR] = 0.81 [95% confidence interval = 0.72 to 0.91]), while having friends who use e-cigarettes generally decreased (31.6% vs. 22.3%, aOR = 0.46, [0.37-0.58]) despite an increase in 2018-2019. Perceived negative views from important others remained stable for both products during 2015-2019, peaked in 2020 (85.2% and 86.2%) before declining slightly in 2021. Perceived public disapproval increased to a peak in 2020 for both products (73.3% to 84.2% for cigarettes and 55.4% to 77.5% for e-cigarettes). In 2021, having friends who used e-cigarettes was associated with current e-cigarette use (relative risk ratio [RRR] = 15.07 [9.94-22.85]) and current dual use (RRR = 3.38 [1.41-8.13]), while important others' negative view toward e-cigarette use reduced the likelihood of current e-cigarette use (RRR = 0.3 [0.2-0.44]).
CONCLUSIONS: Among US youth during 2015-2021, norms consistently indicated denormalization of cigarette smoking. e-cigarette norms showed greater variability, particularly during the coronavirus disease 2019 (COVID-19) pandemic.
METHODS: Respondents were youth aged 12 to 17 from the Population Assessment of Tobacco and Health Study of the United States, Wave 3 (2015-2016) to Wave 6 (2021). Logistic regression models that adjusted for demographics and participation effects assessed norm changes over time and their association with use status in Wave 6.
RESULTS: Between 2015 and 2021, the probability of having friends who smoked cigarettes decreased (26.1% vs. 7.9%, adjusted odds ratio [aOR] = 0.81 [95% confidence interval = 0.72 to 0.91]), while having friends who use e-cigarettes generally decreased (31.6% vs. 22.3%, aOR = 0.46, [0.37-0.58]) despite an increase in 2018-2019. Perceived negative views from important others remained stable for both products during 2015-2019, peaked in 2020 (85.2% and 86.2%) before declining slightly in 2021. Perceived public disapproval increased to a peak in 2020 for both products (73.3% to 84.2% for cigarettes and 55.4% to 77.5% for e-cigarettes). In 2021, having friends who used e-cigarettes was associated with current e-cigarette use (relative risk ratio [RRR] = 15.07 [9.94-22.85]) and current dual use (RRR = 3.38 [1.41-8.13]), while important others' negative view toward e-cigarette use reduced the likelihood of current e-cigarette use (RRR = 0.3 [0.2-0.44]).
CONCLUSIONS: Among US youth during 2015-2021, norms consistently indicated denormalization of cigarette smoking. e-cigarette norms showed greater variability, particularly during the coronavirus disease 2019 (COVID-19) pandemic.