E-Cigarette Beliefs and Intentions Among US Adults Before and After EVALI Outbreak

Purpose: This study examined attitudes, perceived control, perceived norms, intention, and policy support before and after the peak of E-cigarette or Vaping Product Use-Associated Lung Injury (EVALI) cases among 2 independent samples of U.S. adults. Design: This study used a successive independent samples design. Setting: Data was collected through online surveys in July 2019 (n = 521) and October 2019 (n = 536). Subjects: Participants were recruited through the Qualtrics Survey Panel. Eligibility criteria included: 1) 18 years or older, and 2) currently living in the U.S. Measures: The 2 surveys were collected from 2 separate samples examined e-cigarette attitudes, perceived control, perceived norms, intention, and policy support. Analysis: Linear regressions were used to examine the association between time, attitudinal, and belief factors associated with intention and policy support. Results: Participants in the October sample (n = 521) were significantly more likely to have negative attitudes towards e-cigarettes when compared to the July sample (n = 536), F(8,1047) = 52.671, p < .01, R-2 = 0.287. Lower perceived social acceptance towards e-cigarettes and negative attitudes were related to higher support for restricting where e-cigarettes could be used, F(11, 1042) = 63.218, p < .010, R-2 = .401. Higher perceived control over accessing e-cigarettes, but lower social acceptance of e-cigarettes and negative beliefs were associated with higher support for limiting places where e-cigarettes could be purchased, F(11,1039) = 36.200, p < .01, R-2 = .277. Conclusion: Results indicate that EVALI cases may have had an immediate negative effect on attitudes but did not appear to decrease intention to use e-cigarettes. Results could inform future public health campaigns' programming and research. More research is needed to understand the long-term impact of EVALI on e-cigarette use.