{"title":"Association between perceived changes in electronic cigarette retailer density and regulation support among adolescents in China.","authors":"Xibin Sun, Yang Wang, Linnea Laestadius","doi":"10.1136/tc-2025-059312","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":23145,"journal":{"name":"Tobacco Control","volume":" ","pages":""},"PeriodicalIF":4.0000,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Tobacco Control","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1136/tc-2025-059312","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
引用次数: 0
Abstract
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.
背景：青少年对电子烟（电子烟）监管的支持受到各种因素的影响，但对商业环境的研究很少。我们研究了青少年对电子烟零售商密度变化的感知与他们对中国电子烟监管的支持之间的关系，并进一步确定了潜在的潜在途径。方法：数据收集自2022-2023年中国青少年在线横断面调查（N=1988）。使用结构方程模型，我们研究了电子烟零售商密度的感知变化与对电子烟法规的支持之间的关系，包括风味禁令、在线销售禁令、税收和全面禁令。具体来说，这些分析测试了与电子烟相关的积极结果预期和感知健康风险的中介作用，以及电子烟使用状况的调节作用。结果：超过一半的参与者支持风味禁令（58.3%），在线销售禁令（67.7%）和税收（71.7%），但只有43.5%的人支持全面禁止电子烟。感知到的零售商密度的增加与青少年的调节支持呈显著负相关（β=-0.097, 95% CI -0.142至-0.054），由积极的结果预期（β=-0.009, 95% CI -0.017至-0.003）和感知健康风险（β=-0.045, 95% CI -0.063至-0.027）介导。然而，亚组分析发现，这种关联仅在从未使用过电子烟的人群中显著，而在尝试过电子烟的人群中则没有。结论：积极的结果预期和感知到的健康风险同时影响了从未吸过电子烟的青少年感知到的电子烟零售商密度增加与监管支持之间的负相关关系。需要采取措施来解决青少年中电子烟零售商密度增加的问题。
期刊介绍：
Tobacco Control is an international peer-reviewed journal covering the nature and consequences of tobacco use worldwide; tobacco''s effects on population health, the economy, the environment, and society; efforts to prevent and control the global tobacco epidemic through population-level education and policy changes; the ethical dimensions of tobacco control policies; and the activities of the tobacco industry and its allies.
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