How stress influences e-cigarette health message perceptions and intentions to abstain from vaping among young adults who vape.

Purpose: While most U.S. young adults attribute e-cigarette use (vaping) to stress coping, it is relatively unknown how young adults' stress levels influence their e-cigarette health message responses and vaping abstinence intentions.

Methods: In an online crowdsourcing study, young adults who currently vape (N = 346, M = 25.24) were assessed for their past-30-day stress levels. Then, they saw a message about the health effects of vaping and were asked questions about the messages and their vaping abstinence intentions. We performed multiple regressions to examine the main effects of stress levels on message evaluation (message perceptions, effects perceptions) and intentions to abstain from vaping. We then examined the indirect effects of stress levels on abstinence intentions mediated by each message outcome, respectively. Models controlled for sociodemographic characteristics, mental health status, and past-30-day e-cigarette use and cigarette smoking.

Results: Participants with higher stress levels reported more negative message evaluation (ps < 0.05). Additionally, participants with higher stress levels reported lower abstinence intentions via more negative message perceptions (b = -0.02, SE = 0.01, 95 % CI = -0.041, -0.004). Likewise, participants with higher stress levels reported lower abstinence intentions via more negative effects perceptions (b = -0.03, SE = 0.01, 95 % CI = -0.046, -0.008).

Conclusions: Higher stress levels were associated with negative message evaluation among young adults who vape. Additionally, the association of stress levels and abstinence intentions was mediated by negative message evaluation. Public health officials may need to account for stress levels in young adults to increase the effects of e-cigarette health messages on their intentions to abstain from vaping.