(PS1-38) Optimistic Biases for E-cigarette Cessation: Examining Competing Theoretical Models for Young Adults with and Without Chronic Health Conditions

Background: The United States is currently facing an e-cigarette epidemic, especially among youth. Though rates of e-cigarette use generally decreased among adolescents and young adults at the onset of the COVID-19 pandemic, recent reports demonstrate that rates have since rebounded among adolescents and have surpassed prior use rates among young adults. For those with chronic health conditions, the consequences of this dramatic increase in youth nicotine initiation are particularly concerning given their heightened risk for nicotine addiction and nicotine-related morbidity and mortality. Though young adults with chronic health conditions report understanding their greater risk for smoking-related morbidity and mortality, they continue to smoke at similar rates as healthy peers, leading to disruptions in care and increased risk for cardiovascular, respiratory, and pulmonary injury. Consequently, there is an urgent need for research exploring potential psychological mechanisms for continued e-cigarette use to aid in the development of targeted cessation interventions and combat the re-emerging nicotine epidemic. This project aims to 1) explore the role of optimistic biases on harm perceptions, risk responses, and eventual disinterest in cessation in a young adult population without chronic health conditions; 2) contrast these pathways for a young adult population with chronic health conditions; and 3) provide clinical and policy recommendations to prevent vaping initiation and promote cessation.

Methods: Participants (n = 1,827) are drawn from the fifth wave of the Population Assessment of Tobacco and Health (PATH) Study, a national, longitudinal cohort study on tobacco use conducted in collaboration between the National Institutes of Health (NIH) and Food and Drug Administration (FDA). Participants are young adults who endorsed current every/some-day e-cigarette use and completed questionnaires on chronic health conditions. Approximately half of the sample endorsed a chronic health condition (n = 892). A weighted sample, adjusted for oversampling and nonresponse, will be utilized so that the current results are representative of the civilian, noninstitutionalized U.S. Population. Descriptives, t-tests, and chi-squares will be used to examine associations between potential covariates of race/ethnicity, sex, and combustible cigarette use and the primary outcomes within our sample. Path analyses with complex sample weighting will model the impact of optimistic biases on harm perceptions, risk responses, and eventual disinterest in cessation for participants with and without chronic health conditions, controlling for relevant covariates.

Implications: The United States is currently facing an e-cigarette epidemic. It is imperative that we understand psychological mechanisms impacting continued e-cigarette use to identify targets for preventative CBT interventions and improve mental and physical health outcomes for this vulnerable, at-risk population.