E-cigarette use among adolescents in the U.S. has recently tripled. Studies suggest that e-cigarettes may be as addictive as conventional cigarettes, and that adolescents may be at particular risk for nicotine addiction, as well as for the neurological, developmental, and behavioral problems caused by nicotine use. The objective of the present study was to identify potential risk factors for adolescent e-cigarette use, particularly those related to conventional cigarette smoking. Respondents (N = 177; Mean age = 13.23 years; SDage = 0.90; 60.00% female) were recruited from one public middle school and one public high school in Southern California, and completed an in-class survey on smoking and its correlates. A hierarchical logistic regression analysis was used to test attitudes toward cigarette addiction, perceptions of the risks and benefits of cigarette smoking, perceptions of the consequences of cigarette smoking, and exposure to anti-tobacco information as predictors of lifetime e-cigarette use after controlling for cigarette smoking experience. Previous smoking experience and perceived benefits of cigarette smoking significantly predicted the odds of being a lifetime e-cigarette user (OR = .000, p < .01 and OR = 1.141, p < .05, respectively). When exposure to information about the dangers of smoking was taken into account, the effect of perceived benefits was no longer statistically significant, but its effect size implied clinical significance. Although negative physical feelings, social facilitation, and exposure to information about the dangers of smoking did not have statistically significant effects on lifetime e-cigarette use, their effect sizes also implied clinical significance. Attitudes toward cigarette addiction and perceived risks did not predict lifetime e-cigarette use. Prevention programs should be tailored toward adolescents with previous cigarette smoking experience, be designed to address any false perceptions that conventional cigarette smoking may be beneficial or facilitate social benefits, and include information that e-cigarettes have similar negative health effects as conventional cigarettes. Officials should consider regulatory actions that have been effective in preventing conventional cigarette smoking among youth, such as implementing an excise tax or banning flavored cigarettes. Future researchers should examine the relationship between adolescents’ beliefs about the safety of e-cigarettes and e-cigarette use and evaluate possible predictors of the frequency of e-cigarette use.

LLU Discipline

Clinical Psychology




School of Behavioral Health

First Advisor

Morrell, Holly E. R.

Second Advisor

Herbozo, Sylvia

Third Advisor

Neece, Cameron

Degree Name

Doctor of Philosophy (PhD)

Degree Level


Year Degree Awarded


Date (Title Page)




Library of Congress/MESH Subject Headings

Tobacco Use -- Adolescent; Adolescent Behavior; Nicotine -- Health Aspects; Smoking -- Prevention and Control;

Subject - Local

E-cigarretes; Addictive behaviors -- Adolescents; Cigarette Smoking -- Health Effects; Cigarette addiction;



Page Count


Digital Format


Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.


Loma Linda University Electronic Theses and Dissertations

Collection Website



Loma Linda University. Del E. Webb Memorial Library. University Archives