Social cognitive influences associated with susceptibility to nicotine and tobacco use in youth in the ABCD Study.

Introduction: Chronic use of nicotine and tobacco products (NTP) continues to be a leading cause of morbidity and mortality. Uptake is most common among youth and young adults but knowledge about effective prevention and intervention approaches is insufficient. The goal of the present study was to examine the impact of social cognitive factors on NTP risk over time among youth in the national ABCD cohort.

Methods: Participants (n=11,880, 47.8% female) were 9-10 years old at baseline, and completed multiple assessments of NTP use and related cognitions over two years. Structural equation modeling was used to estimate concurrent and prospective associations between social cognitive factors (peer and parent NTP use and perceptions of peer approval and harms from e-cigarette use) and risk for NTP use.

Results: Participant NTP use was primarily of e-cigarettes. Higher levels of parental and especially peer NTP use were significant prospective predictors of greater risk of NTP use. Lower perceived harm from and higher peer approval of e-cigarette use were significant predictors of heightened current but not future NTP risk.

Conclusion: Findings suggest that youth perceptions of peer NTP use is a key predictor of the likelihood of use and a potential target for interventions designed to prevent or reduce e-cigarette and other NTP use in youth.

Implications: findings indicate that perceived peer use is a more powerful predictor of nicotine and tobacco product (NTP) use than cognitive factors or parental use, even at early ages when youth NTP use is uncommon. This suggests a need for additional early intervention targeting perceptions of and responding to peer NTP use.