Date of Conferral

12-31-2025

Date of Award

December 2025

Degree

Doctor of Public Health (DrPH)

School

Health Sciences

Advisor

Patrick Dunn

Abstract

E-cigarette use among U.S. high school students is a significant public health issue. Factors such as mattering, sexual orientation, and gender identity (SOGI) influence e-cigarette use among adolescents, yet few studies have explored the relationship between mattering and e-cigarette use when considering SOGI. This quantitative study explored the association between past 30-day e-cigarette use and mattering among Maine high schoolers while controlling for SOGI and grade level. This correlational cross-sectional study used the 2023 Maine Integrated Youth Health Survey data, and the socioecological model served as the theoretical foundation. A multivariate binary logistic regression analysis indicated a significant association between mattering and past 30-day e-cigarette use, with youth who reported feeling that they mattered to people in their community having higher odds of use (OR = 1.84, 95% CI [1.70, 1.98]). Compared to heterosexual students, adolescents who identified as gay/lesbian had 1.45 times higher odds, and those who identified as bisexual had 1.70 times higher odds of using an e-cigarette in the past 30 days. Across all grade levels, community mattering significantly predicted past 30-day e-cigarette use (p < .001), with higher odds among students in grades 9 (95% CI [1.85, 2.57]) and 10 (95% CI [1.80, 2.39]) compared with grades 11 (95% CI [1.47, 1.94]) and 12 (95% CI [1.51, 2.03]). The results of this study can provide insight into the connection between community, interpersonal level risk factors, and adolescent e-cigarette use. The implications of this research may assist public health practitioners and stakeholders with selecting appropriate health interventions to enhance community-level protective factors, while ensuring they are tailored to youth with the greatest disparities in use.

Included in

Public Health Commons

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