The purpose of this dissertation is to launch a greater understanding of Taylor's Six-Segment Strategy Wheel (SSSW) and how it might pair with purchasing intentions with the use of parasocial interactions and celebrity endorsements. Recent research findings have concluded that younger viewers often consider their parasocial interactions/ relationships to be highly similar to their social interactions/relationships. Moreover, the dissertation presented addresses the question: since friends and family can influence our purchasing intentions; can parasocial influences have the same effect? What is it about parasocial interactions that make them useful to those viewing content? Also, within these interactions, what stands out the most? The present study uses research from the SSSW and other relevant theoretical frameworks to determine what were the most persuasive cues while watching an advertisement. This dissertation conducted two studies to help resolve these problems in more precise detail. First, a content analysis of YouTube comments for the channel Vape Capital's profile videos provided an insight of the visual sensory appeal of vape tricks and clouds. Also, the social component was also present with micro-celebrities on screen and the vaping community as a whole. Both sensory and social segments were the most used segments that influenced purchasing cues. The second study used focus group as a continuation of the research done in study one. Across the three focus groups conducted, the findings were similar to the content analysis. Focus group participants noted currently and retrospectively that they enjoyed the visuals, and were a separate collective group that disassociates themselves from traditional cigarette smokers. Lastly, although participants mostly liked the vapers on screen, they could not influence purchasing intentions exclusively. However, the micro-celebrities and videos conducted sparked purchasing inquiry. Participants were intrigued by the video and the positive interaction and stated that they would want to research the specific products listed in the video. Although this study is not a representation of all celebrity parasocial relationships with links to purchasing intentions, the study can spearhead a line of research to connect interpersonal communication and strategic communication.

The current literature review is aimed to examine the effect of vaping and electronic nicotine delivery on the body. The general population, especially adolescents, may have a misconception about nicotine delivering products being safe or not harmful. However, studies have shown that electronic nicotine delivery systems or products are still detrimental to an individual’s health. This review looks at the impacts of nicotine on the cardiovascular system, the respiratory system, and the brain. The history of electronic cigarettes as well as marketing towards adolescents are also discussed. The results of this literature review indicate that vaping and electronic nicotine delivery systems or products cause harm to an individual’s health although the level of harm, depending on the situation, may not be as severe as that of traditional combustible cigarettes.

Electronic nicotine delivery systems (ENDS), or electronic cigarettes (e-cigarettes), are battery-powered handheld devices designed to aerosolize a solution of nicotine and other chemicals for inhalation. The specific mechanical and chemical features of different ENDS affect the systemic exposure and bioavailability of the different chemicals in e-juices. E-cigarettes can come with different cartridge sizes, power outputs, e-liquid constituents, and nicotine delivery. User puff topography also contributes to varying toxicant exposure. ENDS have demonstrated potential as a cessation tool or alternative cigarette product due to its safety profile relative to the combustible cigarette. E-cigarettes have significantly lower concentrations of biomarkers of tobacco-related toxicant exposure and produce less and less harmful second-hand smoke compared to CC. However, ENDS users have significantly greater concentrations of those same biomarkers, highlighting that e-cigarettes do pose a harm to users’ health, even if that may be lower than CC. The same is observed in e-cigarette second-hand smoke as nicotine and aerosol particles were detected in statistically significant amounts. Its toxicity is only amplified by the misconception that they are safer than CC and thus pose no absolute risk, misleading users to use without caution. Therefore, although ENDS do have the potential in reducing smoking in adults who are already addicted to nicotine, it comes with the risk of dual use of conventional and electronic cigarettes and of attracting non-smokers, especially as seen in the youth. The rise in adolescent e-cigarette use can be attributed to its appeal, of both its flavored e-liquids and its image amongst youth that is perpetuated through the intentional marketing of e-cigarette manufacturers. The latent consequences of e-cigarettes are compounded in adolescents, who are in critical stages of brain development, habit formation, and social development. Youth report having experienced short-term clinical symptoms such as cough, lightheadedness, headache, and shortness of breath. Physiologically, vaping has been found to affect the pulmonary and cardiovascular systems. Vaping alters the equilibrium of the mucociliary clearance system in the pulmonary system and increases the risk of chronic bronchitis, cough, and phlegm. There is increased in pro-inflammatory cytokine secretions, increased alveolar macrophage apoptosis, impairment of phagocytosis, decreased ciliary beating, inhibition of the CFTR channel, and increased mucin expression. In the cardiovascular system, e-cigarette aerosol extract alters angiogenesis, oxidative stress, endothelial dysfunction, sympathetic nerve system activation, platelet activation and anticoagulation inhibition, and cardiac remodeling. E-cigarettes and e-cigarette smoke have also been associated with carcinogenesis in lung epithelium and possibly urothelium. Although e-cigarettes have, on average, less nicotine compared to CC, the significant risk for adolescents to graduate to combustible cigarettes renders this moot. The factors influencing this graduation is modeled through the catalyst model, which details the transition from ‘no use’ to ‘e-cigarette use’ and the transition from ‘e-cigarette use’ to ‘tobacco use.’ Schneider and Diehl hypothesized that the first transition is facilitated through a variety of factors, including flavor, health, price, role models, concealment, and acceptance. The subsequent transition can be attributed to the addiction hypothesis, accessibility hypothesis, and the experience hypothesis. It is clear from the numerous studies conducted, which show students who used e-cigarettes were 4-7 times more likely to report CC use, that e-cigarettes play a catalytic role in enabling the transition to conventional cigarettes. And with increased nicotine exposure, adolescents are subject to impairments in working and verbal memory during abstinence, changes in drug sensitivity and reward-related manifestations in adulthood, more severe dependence during adolescence, and deficits in attentional performance, impaired serial pattern learning, impaired context conditioning and increased anxiety and depressive-like behaviors in adults. They also have reduced control of motivation, reward, and pleasure. This culminates to the gateway hypothesis which states that nicotine can serve as a gateway drug that lowers the youths’ threshold for addiction to opioids, alcohol, and other agents. Recently, there has been a dramatic increase in cases of EVALI or e-cigarette or vaping associated lung injury, particularly in the adolescent population that is more likely to use illicit e-cigarettes than their adult counterparts. EVALI presents with a wide range of respiratory, gastrointestinal, and constitutional symptoms and is characterized as a sterile exogenous pneumonitis-like reaction with variable degrees of diffuse alveolar damage. Vitamin E acetate, common in illicit products, is strongly linked to this outbreak due to its presence in a vast majority of bronchoalveolar lavage fluid samples of confirmed EVALI cases. As ENDS use has increased amongst adolescents, so have its latent consequences. A coordinated effort from policy makers, public health agencies, healthcare providers, researchers, and especially parents and educators is essential for successful protection of this vulnerable population.

Electronic Nicotine Delivery Systems (ENDS) are methods of delivering nicotine without combustion, which happens in cigarettes. These devices consist of a heating element, a battery, and a tank which stores eliquid. Over the years these devices have become more powerful, and capable of increased delivery of nicotine. There is a large variety of flavors and devices, which causes trouble for standardized studies. These devices were created to help cigarette users quit smoking; however, they are associated with significant dual use. ENDS produce lower levels of most toxic chemicals when compared to cigarettes, and significantly increased levels when compared to not smoking. Newer generation ENDS have capabilities of producing levels of reactive oxygen species and carbonyl compounds at levels similar to cigarettes. ENDS use has detrimental effects on the genome, immune system, and lung function due to exposure from these chemicals. These effects are at lower levels when compared to cigarette use. Chronic ENDS use has been associated with chronic obstructive pulmonary disorder (COPD), with an even higher association with dual use. ENDS use also causes DNA adduct formation, and activates protein kinases, nicotine acetylcholine receptors and other pathways for lung cancer as cigarette use. The full health effects of ENDS use are still unknown, from the currents studies it is clear that its use is not without harm.

We investigated the prevalence of vaping among college students in South-central Appalachia in the United States and explored factors which were associated with and could predict vaping among the college students. A sample of 498 enrolled students voluntarily completed a self-report REDCap health survey questionnaire in 2018. Outcome variable was use of electronic cigarettes categorized as yes/no. Independent variables included risky behaviors such as texting or emailing while driving, riding in a car with someone who had been drinking, history of protected and unprotected sexual intercourse, age at first intercourse, and type of contraceptive used. Covariates were age, gender, ethnicity/race and high school location. The first category was used as reference. Binary logistic regression was used to identify factors associated with and predicting vaping. Mean age of participants was 20.93(± 8.26), 62.9% were female, a majority (76.5%) were non-Hispanic White, and 43.2% reported vaping at some point in their lives. Initial univariate analysis showed gender (p < 0.0001), seat belt usage (p = 0.002), texting or emailing while driving (p = 0.002), riding in a car with someone who had been drinking (p = 0.001), history of sexual intercourse (p < 0.001), coitarche (p = 0.026), use of birth control pills and withdrawal method were associated with vaping. Adjusting for co-variates, gender (p < 0.002), county of high school (p < 0.009) and texting and e-mailing while driving (0.05), seat belt usage (0.04) remained significant. Vaping was highly prevalent (43.2%) among our participants. Gender, location of high school, texting/emailing while driving and seat belt usage are predictors of vaping among these students.

No description available.

Electronic cigarettes (ECIGs) operate by heating a nicotine-containing solution resulting in an inhalable aerosol. Nicotine delivery may be affected by users’ puffing behavior (puff topography), and little is known about the puff topography of ECIG users. The purpose of this study was to examine the extent to which a mouthpiece-based topography measurement device influences the acute effects associated with ECIG use. Twenty-nine experienced ECIG users completed two sessions differing only by the presence of a mouthpiece-based topography recording device. In both sessions, participants completed one 10 puff, 30 sec inter-puff interval (IPI) ECIG-use bout and another 90 minute ad libitum bout. Acute ECIG effects (plasma nicotine concentration, heart rate [HR], and subjective effects) were largely unaffected by the presence of the topography recording device. Evaluating ECIG puff topography through clinical laboratory methodology is necessary to understand the effects of these products (including toxicant exposure) and to inform their regulation.

Background: Use of electronic cigarettes (EC) has dramatically increased in the United States since 2010 with a forecasted growth of 37% between 2014 and 2019. There is little research on e-liquid nicotine concentration from domestic manufacturers. However, limited research outside of the U.S. found wide inconsistencies between the labeled concentration of nicotine in e-liquids and the actual nicotine concentration. Methods: The seven most popular online manufacturers or distributors were identified. E-liquid samples of the five most popular flavors from each manufacturer were purchased in nicotine concentrations of 0 mg/ml and 18 mg/ml. Of the samples purchased (n=70), all were labeled as produced in the United States of America (USA). The researchers anonymized the samples before sending them to an independent university lab for testing. Results: The 35 e-liquid samples labeled 18 mg/ml nicotine measured between 11.6 and 27.4 mg/ml (M=18.7 SD=3.3) nicotine. The labeled 18 mg/ml samples measured as little as 35% less nicotine and as much as 52% greater nicotine. In the 35 samples labeled 0 mg/ml, nicotine was detected (>0.01 mg/ml) in 91.4% of the samples (Range = 0 to 23.9 mg/ml; M=2.9; SD=7.2). Six samples from two manufacturers labeled as 0 mg/ml were found to contain nicotine in amounts ranging from 5.7 mg/ml to 23.9 mg/ml. Conclusion: This study demonstrates the nicotine labeling inaccuracies present in current e-liquid solutions produced in the U.S. Incorrect labeling poses a significant risk to consumers and supports the recent regulation changes enacted by the FDA. Additional routine testing of nicotine concentrations should be conducted to evaluate the effectiveness of the regulations on future e-liquid production.

E-cigarette (e-cig) use is rising, but much is unknown about the effects of its vapor. This vapor contains chemicals such as propylene glycol, a known antimicrobial, and nicotine, whose derivatives are carcinogenic. Here, we study the effects of vaping on resident bacteria of the oral cavity and on oral cell inflammation. Oral streptococci are major residents in the oral cavity, with S. mutans the primary cause of dental caries. Growth and biofilm formation have been shown to be enhanced upon exposure to traditional cigarette smoke in vitro. In this study, we analyzed the effects of e-cig vapor on growth and biofilm formation in S. mutans, S. sanguinis, and S. gordonii. Organisms and oral epithelial cells were treated using nicotine-free and 3mg nicotine vapor, as well as double-shot menthol freeze flavored 3mg nicotine vapor in a vape chamber designed to phenocopy physiologically relevant exposure. Nicotine-independent inhibition of growth occurred upon exposure in all three bacterial species. Interestingly, biofilm formation was enhanced in the S. mutans while decreased in S. sanguinis and S. gordonii. Epithelial cells showed activation of survival pathways by Western Blot upon exposure to only e-cigarette vapor as well as co-culturing of bacterial and oral epithelial cells at a multiplicity of infection of one The pioneer colonizers S. gordonii and S. sanguinis generally antagonize caries-causing S. mutans, which can become a predominant member of the community under appropriate conditions, leading to dental caries formation. The observed decrease in the biofilm formation of the commensals S. sanguinis and S. gordonii upon e-cig vapor exposure indicates the opportunistic colonization of S. mutans, whose biofilm-forming abilities increased. Following e-cig usage, dental caries and cancer in the oral epithelium may result from this dysbiosis of the microbiome.

Although there has been progress in trying to decrease the use of cigarette smoking, a new method of smoking has evolved which is rapidly increasing, namely vaping. Adolescents who participate in smoking are more likely to increase smoking frequency if they believed that it is self-defining (“I smoke cigarettes” versus “I am a smoker”). While there has been evidence to support the claim that internal motives for smoking are correlated with smoker identity development, there has been none, to our knowledge, found for vaping identity. Due to the similarities of smoking and vaping, it is important to discover whether those who vape also have an identity similar to those who smoke. In other words, with vaping being a new technology, do users identify themselves as “I am a vaper” or “I vape e-cigarettes”? The way in which users identify themselves may have important implications for intervention efforts. Further, smoking is a type of substance abuse, and substance abuse, primarily alcohol, has been linked to identity status, identity distress, and psychopathology. Smoking has been linked to alcohol use and abuse, but it is unclear if smoking is related to similar identity and adjustment variables, particularly internalizing symptoms, in the same way as alcohol use. Thus, the purpose of this study was to explore the associations between smoking, vaping, identity, and psychopathology. Using college student participants (N = 303) who completed anonymous online surveys for course credit, four hypotheses were tested, but none was confirmed. Possible reasons for the lack of significant findings are discussed. Despite the lack of findings in regard to the relationship among the study variables, the new concept and measure of vaping identity proposed in this thesis appear to be a potentially valid and useful avenue for future research.