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Association between perceived changes in electronic cigarette retailer density and regulation support among
Xibin Sun1,2, Yang Wang3,4, Linnea Laestadius5
1School of Public Health, Peking University, Beijing, China.
Background:
Adolescents' support for the regulation of electronic cigarettes (e-cigarettes) has been documented to be influenced by various factors, but the commercial environment has rarely been studied. We examined the relationship between adolescents' perceived changes in e-cigarette retailer density and their support for e-cigarette regulations in China and further identified potential underlying pathways.
Methods:
Data were collected from a national online cross-sectional survey of Chinese adolescents during 2022-2023 (N=1988). Using structural equation modelling, we examined the association between perceived changes in e-cigarette retailer density and support for e-cigarette regulations, including flavour bans, online sales bans, taxation and comprehensive bans. Specifically, the analyses tested the mediating effects of e-cigarette-related positive outcome expectancy and perceived health risk, along with the moderating effects of e-cigarette use status.
Results:
More than half of the participants supported the flavour ban (58.3%), the online sales ban (67.7%) and taxation (71.7%), but only 43.5% supported the comprehensive ban on e-cigarettes. Perceived increases in retailer density were significantly negatively associated with adolescents' regulation support (β=-0.097, 95% CI -0.142 to -0.054), mediated by positive outcome expectancy (β=-0.009, 95% CI -0.017 to -0.003) and perceived health risk (β=-0.045, 95% CI -0.063 to -0.027). However, subgroup analysis found this association to be significant only in never users, rather than those who had tried e-cigarettes.
Conclusions:
Positive outcome expectancy and perceived health risk simultaneously influenced the negative association between perceived increases in e-cigarette retailer density and regulation support among adolescents who never vaped. Measures are needed to address the perceptions of increasing e-cigarette retailer density among adolescents.
