Understanding racial/ethnic differences in e-cigarette outcome expectancies among early adolescents: findings from...

E-cigarette expectancies, which may differ by race/ethnicity, play a crucial role in shaping youth e-cigarette use. Observed differences by race/ethnicity, however, may reflect racial/ethnic variations in social determinants of health, such as socioeconomic status (SES). This study examined the extent to which race/ethnicity was uniquely associated with youths' positive and negative e-cigarette expectancies, after adjusting for SES and neighborhood disadvantage, and individual, family, and peer risk factors.

Analyses included 8,814 Black (15.0%), Latinx (22.8%), and White (62.2%) 12 to 14-year-old participants in the Adolescent Brain Cognitive Development Study. Applying a three-stage analytic approach, hierarchical regression analyses examined associations of positive and negative e-cigarette expectancies with race/ethnicity in three blocks, with age and gender in block 1, adding SES and neighborhood disadvantage in block 2, and individual, family, and peer risk factors in block 3.

Black and Latinx (relative to White) race/ethnicity and Latinx (relative to Black) race/ethnicity were associated with positive expectancies (p < 0.001) in blocks 1 and 2 but were non-significant in block 3. Black and Latinx (relative to White) race/ethnicity and Latinx (relative to Black) race/ethnicity were associated with lower negative expectancies (p < 0.001) in block 1, but were no longer significant after adding SES and neighborhood indicators in block 2. Perceived risk, perceived peer disapproval, and curiosity about e-cigarettes were associated with positive and negative expectancies.

The results highlight the importance of considering associations of race/ethnicity with e-cigarette expectancies in the context of social determinants and individual and interpersonal factors in e-cigarette prevention.