General and specific risk and protective factors for cigarette and electronic nicotine delivery system (ENDS) use

Electronic nicotine delivery system (ENDS or e-cigarette) use is at least as common as cigarette use among today’s young adults. However, most prevention approaches are based on risk and protective factors (RPFs) that were identified with respect to cigarette use alone. To the extent that RPFs differ for cigarette and ENDS use, tailored approaches are needed to reduce the burden of nicotine use. In the current study, we examined both shared general RPFs and substance-specific RPFs across a developmental period spanning early adolescence to young adulthood, with the goal of identifying upstream preventive intervention targets for cigarette and ENDS use. The current study used data from the Community Youth Development Study (n = 4407) collected at 7 time points from early adolescence (age 12) through young adulthood (age 26). Using longitudinal structural equation modeling, we examined the contributions of adolescent and young adult RPFs to young adult cigarette and ENDS use. We examined general protective factors (e.g., family bonding and peer opportunities for prosocial involvement), cigarette-specific risk (e.g., friends’ cigarette use and permissive community norms), and peer polysubstance use. General protective factors assessed in early adolescence had an indirect association with young adult cigarette and ENDS use, mediated through later RPFs. Whereas both cigarette-specific RPFs and peer polysubstance use predicted ENDS use in young adulthood, only cigarette-specific RPFs were related to cigarette use in young adulthood. Our findings suggest that, although addressing known RPFs holds value for preventing ENDS use, additional prevention targets should also be considered. Early prevention approaches might seek to strengthen protective factors, whereas later prevention approaches might target cigarette beliefs for cigarette use and peer polysubstance use for ENDS use.