College Students Perceptions and Use of E-Cigarettes

Dr. JoAnn
Introduction
Electronic cigarettes (e-cigarettes) are products that deliver
nicotine-containing aerosol by heating a solution consisting
of propylene glycol or glycerol (nicotine), and flavoring
agents. The US patent application describes the e-cigarette
device as an electronic atomization cigarette that functions
as substitutes for quitting smoking and cigarette
substitutes. There has been swift market diffusion of ecigarettes despite considerable controversy about disease
risk and toxicity of e-cigarettes. Empirical evidence on
short- and long-term health effects is minimal.

1
Kleinfelder ,

1
Kotecki ,

Dr. Jerome
Dr. Rebecca
Dr. Jagdish
2
2
2
Alyssa Ham BS, Elizabeth Reed BS, & Allison Anton BS

1
Khubchandani

Graphs and Charts

Fig. 1

Fig. 2

Purpose
Limited research on college students perceptions, beliefs,
and use of e-cigarettes exists. This study aimed to estimate
the prevalence of e-cigarette use and identify correlates of
use among a large, university random sample of college
students.

Results-Regulation
Overall, 89% believe that inspection of e-cigarette
manufacturers is very important or important. A OneWay ANOVA revealed no significant differences between
political affiliation and manufacturer inspection. State
regulation of e-cigarette sales was identified as the preferred
gate-keeper over federal or local regulation regardless of
political affiliation (Fig. 4). Ninety-one percent believe that
persons under 18 should not be allowed to purchase ecigarettes and 67% believe cigarettes should only be used in
designated campus areas for students and faculty. Chi-square
analyses revealed no significant differences for underage
purchasing and designated areas by political affiliation.

Discussion
Fig. 1

Methods
A 4-page pencil-and-paper survey was completed by
undergraduate students (N=420) attending randomly
selected lecture classes representing a cross section of
academic majors at a large mid-western university.
The survey included questions pertaining to health
effects, personal usage, marketing and regulation of ecigarettes.

1
Brey ,

Fig. 3

The majority of respondents were female (67.8%),

white (78.6%), full time status (98.6%) and freshman
(54.5%). Respondents identified as Democrats
(29.8%), Republicans (34%), Independent (22.9%) and
Other (6.4%).

Fig. 3

Results-E-Cigarette Use

Descriptive analyses revealed that the majority
(67.4%) do not use e-cigarettes. More than half
(55.5%) reported that friends use e-cigarettes (Fig. 1).
The majority of users (79%) were introduced to ecigarettes by friends. The average age that anytime
users began experimenting with e-cigarettes was 18.
Over 90% on non-users were not at all likely to use
an e-cigarette if offered to them.

Findings from this study suggest that current college-age

students are not highly engaged in e-cigarette use which is
supported in prior studies (a & b). In comparison to the
Centers for Disease Control recent figures (c) that reported
growing e-cigarette use among middle-and high-school
students, this study suggests that current college students have
not been influenced to the same degree. In addition, nonusers appear unlikely to try an e-cigarette. This study reveals
that the majority believe e-cigarettes are less harmful to
personal health and the environment as compared to real
cigarettes. However, most feel that e-cigarettes should only
be used in designated areas on campus and in public places.
To the best of our knowledge, this is the first study that has
explored students political affiliation and preference for
regulation of e-cigarette sales and manufacturer inspection. It
appears that the majoritys conviction for regulation on both
issues is not politically driven. However, specificity for state
regulation over federal and local control is preferred by the
three designated parties.
These findings may be helpful when designing health policy
that would be decided at the voting booth with regard to
regulatory issues. The plethora of conflicting studies as to ecigarette safety have not revealed a definitive answer, but not
knowing can be dangerous if the assumption that e-cigarettes
are less harmful to health than real cigarettes is false.
Therefore, knowing what students believe from this studys
findings may help when designing health-related programs
about e-cigarettes on college campuses.

Results-Health Effects
Fifty percent believe that e-cigarettes are not safe to
use (Fig. 2), may cause users to smoke real cigarettes
(53.8%) and cause nicotine addiction (64%). Overall,
compared to real cigarettes, e-cigarettes were
perceived to be less harmful to personal health (65.5%)
and less harmful to the environment (70%). However,
respondents who used e-cigarettes once or twice were
significantly more likely than non-users to believe ecigarettes are less harmful to personal health than real
cigarettes. Only 14.8% were concerned or very
concerned about second-hand emissions from ecigarettes. The majority of non-users (65%) were not
at all likely to try an e-cigarette (Fig. 3).

Results-Marketing and Advertising

Eighty-eight percent reported having seen
advertisements for e-cigarettes and ranked television,
internet and magazines as the top venues. Those who
have purchased e-cigarettes (n=80) cited drugstores,
smoke shops and gas stations as the most likely places
buy e-cigarettes.

Fig. 4

This study is limited to a large mid-western university and

should not be generalized to academic institutions outside of
these parameters. While all responses were anonymous, the
possibility of those answering in a socially acceptable manner
may be a threat to validity of these findings.

References
(a) Sutfin, E. L., McCoy, T. P., Morrell, H. E. R., Hoeppner, B. B., & Wolfson, M.
(2009). Electronic cigarette use by college students. Drug and Alcohol
Dependence, 131, 214-221.
(b)Trumbo, C. W. & Harper, R. (2013). Use and perception of electronic cigarettes
among college students. Journal of American College Health, 6(3), p. 49-55.
(c)Corey, C., Wang, B., Johnson S. E., Apelberg, B., Husten, C., King, McAfee, T.
A., Bunnell, R., PhD, Arrazola, R. A., & Dube, S.R. (2013). Notes from the field:
Electronic cigarette use among middle and high school students-United States.
Morbidity and Mortality Weekly Report (MMWR), 2011-2012, 62(35), 729-730.

Denotes professors of health science in the department of Physiology

and Health Sciences
2

Denotes undergraduate students pursuing MPH programs at the

University of Kentucky, Indiana University and a career in pediatric
public health