Title : The vaping ecosystem: Social, school, and media predictors of e-cigarette use among Florida teens
Abstract:
Aims
As an epidemic, U.S. teenagers’ electronic vapor product use increased by 1800% and having ever used e-cigarettes increased 4 times from 2011 to 2019. In Florida alone, 11.4% of middle and high schoolers reported vaping in 2022, a fivefold increase from 2011, highlighting the urgency of understanding what drives this behavior. Grounded in ecological systems theory, this research examines influences within interpersonal, institutional, and media-based contexts and their associations with adolescents’ vaping behaviors.
Method
Middle and high school students in Florida reported past 30-day electronic vapor product usage in 2022 (n=52,165). Influential factors were divided into ecological categories: school-
related; media-related; and social relationships. Associations between predictors and vaping were examined by grade, gender, and ethnicity/race, using multivariate binary logistic
regression.
Results
Positive associations between vaping exposure within each ecological level and electronic vapor product usage were indicated, with greater vaping likelihood for females, high schoolers, and non-Hispanic White adolescents. Social predictors were most strongly associated with vaping. Best friends offering vapes increased odds of teen vaping nearly 40 times; others vaping at home doubled the odds of usage; and witnessing school staff vaping on campus increased odds by 46%. Students’ participation in anti-vaping school events increased odds of use by 6%, while earning good grades and attending schools with rules against vaping had protective effects, reducing vaping odds by nearly 40%. Teens seeing characters vaping on video were 1.2 times more likely to have vaped in the past 30 days.
Notably, traditional advertising formats such as radio and print showed stronger associations with vaping, suggesting that indirect media exposure warrants greater attention in prevention efforts.
Conclusions
Understanding the role of ecological influences in adolescents’ life spaces can holistically inform vaping prevention efforts. Future interventions such as peer-based interventions and vaping prevention efforts in schools and other immediate environments where teens engage in close interpersonal interactions are a key starting point, amid the macrosystemic appeal of vaping to adolescents through advertising and various forms of media portrayals.
