Date of Conferral





Public Health


Michael Dunn


The increase in use of e-cigarettes in adolescents is a major public health concern that must be addressed. Research studies showed some e-cigarettes contained varying amounts of nicotine and sever cancer-causing chemicals. The purpose of this quantitative, cross-sectional study was to assess the perception of harm (dependent variable) from using e-cigarettes and being exposed to state and school-based antitobacco programs (independent variable) and to determine if the association was modified by socioeconomic status or area of residence. Attitude-social influence-self-efficacy theory was the chosen theory for research and suggests that attitude, social influence, and self-efficacy variables can be persuaded via specific health promotion activities. Texas students enrolled in 6th to 12th grade of an eligible school who voluntarily consented to participate and received written authorization from a parent were included. Nearly half of participants out of N=9,239 adolescents considered e-cigarettes very dangerous, yet more than half reported using the device. Ordinal logistic regression was used to determine the relationship between the independent and dependent variables. The results concluded that though majority of adolescents perceived e-cigarettes as harmful, exposure to state and school antitobacco programs are not completely effective at discouraging use. The findings of the study may provide potential impact for positive social change for adolescents and tobacco cessation by increasing understanding of what factors are associated with increased/decreased perception of harm. Results of the study may encourage public health professionals to create and disseminate tailored antitobacco educational information including school and state activities and resources.