Primed for Positive Perceptions? Applying the Acquired Preparedness Model to Explain College Students' E-cigarette Use and Dependence

Objective: College students use electronic nicotine delivery systems (ENDS) more often than any other US demographic group. In a novel application of the acquired preparedness model, we examined how proximal (e.g., cognitions) and distal (e.g., dispositional) influences accounted for ENDS use and dependence.

Participants: Undergraduates ( = 1075; 72% female, 74% White) from seven US campuses completed an online survey between October 2019-March 2020.

Methods: We modeled ENDS use and dependence, respectively, as zero-inflated Poisson distributions with impulsivity as an independent variable and perceived risks and benefits of e-cigarettes as mediators.

Results: Students higher in impulsivity perceived more benefits and, in turn, reported greater ENDS use and dependence. Curiosity and friends' use motivated ENDS initiation; stress management and nicotine motivated continued use.

Conclusions: ENDS interventions should be tailored to students higher in impulsivity, as they hold more favorable perceptions of ENDS, and should enhance skills to manage stress and nicotine cravings.