Understanding racial/ethnic differences in e-cigarette outcome expectancies among early adolescents: findings from the Adolescent Brain Cognitive Development Study.

Abstract

Introduction: 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.

Methods: 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.

Results: 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.

Discussion: 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.