Association of Perceived Stress, Social Support, and Self-Esteem with E-Cigarette Use Among U.S. College-Aged Young Adults.

Background: Given that college life is a major life-changing and stressful event for many young adults, they may use e-cigarettes to manage their stress, which in the long run could be detrimental to their health. Furthermore, perceived social support and self-esteem are important factors that might influence young adults' e-cigarette use behavior. This cross-sectional study examines the associations of perceived stress, social support, and self-esteem with e-cigarette use among U.S. college-aged young adults.

Methods: Students (aged 18-24 years, n = 220) attending Slippery Rock University of Pennsylvania between February-May 2023 were recruited to complete an online survey. The outcome variables were current (past 30 days) and ever e-cigarette users, while the explanatory variables were perceived stress, perceived social support, self-esteem, and socio-demographics. Data was analyzed using bivariate and multivariable logistic regression models.

Results: About 30.1% and 55.0% of participants were current users and ever users of e-cigarettes, respectively. Participants who perceived high stress (vs. low stress) were 12.4 (Adjusted Odds ratio (aOR) = 12.39, p = 0.02) and 7.4 (aOR = 7.37, p = 0.04) times more likely to be current users and ever users of e-cigarettes, respectively. For every one-unit increase in self-esteem score, the likelihood of participants being current e-cigarette users decreased by 7% (OR = 0.93, p = 0.01).

Conclusion: Perceived stress and self-esteem are significantly associated with e-cigarette use among college-aged young adults. Public health efforts should focus on stress reduction, healthy coping strategies, and improving self-esteem in order to prevent e-cigarette use among this population.