College students' underlying beliefs about using e-cigarettes: an application of the reasoned action approach

Background.The purpose of this study was to explore the underlying behavioral beliefs, normative beliefs, and control beliefs about e-cigarette use among college students using the Reasoned Action Approach. Methods.This study used a sequential mixed-methods design over 3 Phases. During Phase 1, salient beliefs were elicited via an online survey (n = 58); chi-square analyses were conducted to examine differences between e-cigarette users and non-users. Using data from Phase 1, we developed survey items and assessed initial factor loadings via a principal component analysis (n = 49) in Phase 2. In Phase 3, the survey was administered to a larger sample of college students (n = 499) to explore the association between participants' underlying beliefs and the RAA constructs. Results.During Phase 1, no significant differences in salient beliefs were found between e-cigarettes users and non-users; thus, both groups were included in all phases. During Phase 2, 148 items were developed, piloted to test factor loadings, and reduced to 60 items, which loaded onto eight factors (two factors per construct). In Phase 3, we found underlying beliefs, such as believing e-cigarettes would help relieve stress or one's mentors would not approve of their use, were related to global RAA measures-attitude and injunctive norms, respectively. Conclusions.Overall, our sample of college students endorsed negative beliefs associated with e-cigarette use and did not identify with those who they believed to use these products. Parents were important referents for this sample, whose opinions may influence college students' behavioral decision-making process.