E-Cigarette Beliefs and Intentions Among U.S. Adults Before and After EVALI Outbreak

This study examined attitudes, perceived control, perceived norms, intention, and policy support before and after the peak of E-cigarette or Vaping Product Use-Associated Lung Injury (EVALI) cases among 2 independent samples of U.S. adults.

This study used a successive independent samples design.

Data was collected through online surveys in July 2019 (n = 521) and October 2019 (n = 536).

Participants were recruited through the Qualtrics Survey Panel. Eligibility criteria included: 1) 18 years or older, and 2) currently living in the U.S.

The 2 surveys were collected from 2 separate samples examined e-cigarette attitudes, perceived control, perceived norms, intention, and policy support.

Linear regressions were used to examine the association between time, attitudinal, and belief factors associated with intention and policy support.

Participants in the October sample (n = 521) were significantly more likely to have negative attitudes towards e-cigarettes when compared to the July sample (n = 536), F(8,1047) = 52.671, p < .01, R² = 0.287. Lower perceived social acceptance towards e-cigarettes and negative attitudes were related to higher support for restricting where e-cigarettes could be used, F(11, 1042) = 63.218, p < .010, R² = .401. Higher perceived control over accessing e-cigarettes, but lower social acceptance of e-cigarettes and negative beliefs were associated with higher support for limiting places where e-cigarettes could be purchased, F(11,1039) = 36.200, p < .01, R² = .277.

Results indicate that EVALI cases may have had an immediate negative effect on attitudes but did not appear to decrease intention to use e-cigarettes. Results could inform future public health campaigns' programming and research. More research is needed to understand the long-term impact of EVALI on e-cigarette use.