Depression and perceptions of social norms and harms for electronic and combustible cigarette use: Associations with tobacco use in college students

Abstract

Both e-cigarette use (i.e., vaping) and dual use of e-cigarettes and cigarettes are prevalent among young adults. To inform future development of interventions that target use, this study examined associations between three forms of tobacco use (exclusive vaping, exclusive cigarette use, and dual use), psychosocial factors (perceptions of risks and social norms of tobacco use), and mental health (depression symptoms) among a large sample of U.S. college students. In this cross-sectional study ( N ​= ​2115), three hierarchical logistic regressions were used to test whether psychosocial factors and depression were associated with tobacco use status. Depression was positively associated with all forms of tobacco use. Perceived risks of cigarettes, risks of vaping, and social norms of vaping were associated with exclusive vaping. Perceived risks of vaping and vaping social norms were also associated with cigarette use. Lastly, the interaction between depression and perceived vaping social norms were associated with dual use. Depression and perceptions of harm and social norms of tobacco use may be associated with dual use, exclusive vaping, and exclusive cigarette smoking. Development of interventions targeting tobacco use in college settings that address these factors may yield useful implications. • Depression is positively associated with e-cigarette, cigarette, and dual use. • Perceived risks of cigarettes and vaping are associated with exclusive vaping. • Perceived social norms of vaping are associated with exclusive vaping. • Perceived vaping risks and social norms are associated with cigarette use. • Perceived vaping social norms moderated relations of depression and dual use.