Social network characteristics of 8th grade students using vaping products: Implications for network-informed vaping prevention

Peter Wyman, Kelly Rulison, Trevor Pickering, Anthony Pisani, Dorothy Espelage, Karen Schmeelk-Cone, Chelsea Keller


Introduction: Surging rates of adolescent vaping in the U.S. threaten to undo decades of progress in reducing nicotine exposure. High school student use of electronic vaping products (EVPs) rose from 1.5% in 2011 to 20.8% in 2018. Exposure to nicotine, the primary stimulant used in EVPs, increases risk for multiple adverse health outcomes. Research-informed vaping prevention is needed. Interventions utilizing social networks have reduced multiple health problems (e.g., HIV risk behaviors). Recent research has identified social-ecological factors as major drivers of adolescents’ decision to vape, yet minimal research has focused on social networks of adolescent EVP users. Methods: Among all 8th graders in 3 middle schools in upstate New York, 90% enrolled (N=335) and completed measures of EVP use, attitudes and intentions to use EVPs in future. Friendship networks were constructed by asking students to nominate up to 7 close friends in their grade. Likewise, student-to-adult networks were constructed from nominations of up to 7 supportive adults at school. Network variables were constructed in three domains: (a) integration into the peer network (vs. isolation) including betweenness and coreness; (b) clustering of EVP users; and (c) connections to trusted adults. Based on students’ report of recent EVP use (past 30-day) and future intentions, students were categorized as: recent EVP Users (n=33; 10.3%) and two nonuser types: Resolute Nonusers (n=223, 65%), indicating they would definitely not use EVPs in next year; and Vulnerable Nonusers (n=75; 24.8%), indicating they might use. Status did not vary by sex or age. Multi-level models (students nested in school) tested associations between network variables and recent EVP user status. Results: Recent EVP users and nonusers were comparable in-degree nominations and betweenness. Recent EVP users, however, named fewer friends than Resolute Nonusers and had fewer reciprocal friendships than Vulnerable Nonusers. EVP users were twice as likely as nonusers to have friends who were users or vulnerable. Resolute nonusers had the most friends who viewed vaping as harmful (users the fewest). Naming no supportive adults at school was twice as common among EVP users (56%) as resolute nonusers (22%), with vulnerable group intermediate; EVP users had the most friends with no trusted adults. Discussion: 8th grade EVP users are early adopters. Our finding suggest that EVP does not penalize social status in 8th grade. However, EVP users may have fewer strong bonds with same-grade peers. EVP users are more connected to users and to students with favorable EVP attitudes, consistent with diffusion of EVPs through peer networks alongside tendency toward homophily. EVP users being least connected to school adults is consistent with lower bonding to school. Testing multiple targets for network informed vaping prevention is warranted, including peer norms and increasing connections to adults. EVP users’ integration into the peer network suggests that use of appropriately trained peer leaders could be effective in reducing acceptability of vaping.

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