E-cigarette use susceptibility among youth in Mexico: The roles of remote acculturation, parenting behaviors, and internet use frequency.

Introduction: Adolescent electronic cigarette (e-cigarette) use is increasing worldwide, raising concerns about its impact on youth development. Remote acculturation may influence the e-cigarette use cognitions of youth in Mexico by influencing their media use, thereby contributing to their e-cigarette use susceptibility. This study examined whether remote acculturation was associated with youth internet use frequency, and whether youth internet use frequency, in turn, was associated with youth e-cigarette use susceptibility. Because parenting behaviors can relate with lower tobacco and media use (e.g., internet use), this study also examined the associations of parental media restrictions and mother's parenting practices with youth internet use frequency and e-cigarette use susceptibility.

Methods: Data came from a school-based survey with middle school students in Mexico who had never tried e-cigarettes (N = 6004; 52.6% female; Mage = 13.07 years). Students completed measures of remote acculturation, parental media restrictions, mother's parenting practices, internet use, and e-cigarette use susceptibility.

Results: Structural equation analyses suggest that U.S. American cultural orientation may increase youth e-cigarette use risk by way of higher youth internet use. Mexican cultural orientation and parental media restrictions may reduce youth e-cigarette use risk by way of lower youth internet use.

Conclusions: Preventive interventions to reduce Mexican youths' intention to try e-cigarettes could benefit from efforts to reduce youth internet use and from media literacy interventions that inform parents and youth about the influence of internet use on youth e-cigarette use.