Development of a measure assessing perceptions of e-cigarettes: A mixed methods approach

Tobacco use is the leading cause of preventable death in the United States (U.S.), killingmore than 480,000 people each year. In recent years, we have seen a steady decline in cigarette smoking but have seen increased alternative tobacco product use (e.g., electronic cigarettes). Positive perceptions of e-cigarettes are associated with increased e-cigarette use (Amrock, Zakhar, Zhou, & Weitzman, 2015; Chen-Sankey & Kong, Choi, 2019; Pokhrel, Fagan, Kehl, & Herzog, 2015; Simmons et al., 2016). However, studies assessing the perceptions of e-cigarettes vary widely and do not adequately capture perceptions of social norms and the addictiveness of e-cigarettes. The current study used qualitative and quantitative data to create a valid and reliable measure of e-cigarette perceptions. Study 1 included focus groups assessing adultsâ?? perceptions of e-cigarettes in El Paso, TX. In Study 2, a measure of perceptions of e-cigarette use was created with the following constructs: Perceptions of Harm (e.g., harm of e-cigarettes), Perceived Behavioral Control (e.g., addiction perceptions), and Social Norms (e.g., use among friends and family, and social acceptability among friends and family). In this study, participants (n =80) provided additional qualitative data to assess the content of the items in a sample from Prolific. Finally, Study 3 refined the measure and tested the hypothesized three-factor structure of the measure in a Prolific sample of 400 participants. Results indicate that the hypothesized factor structure provided good model fit and the measure demonstrated good convergent and discriminant validity. Future research should assess the inclusion of the Perceptions of Benefits and Long-Term Health Effects. Additionally, future studies should attempt to shorten the current measure. This measure may be used in the creation of policy and interventions