Stress coping strategies among college students ... · E-cigarettes and perceived stress Cigarette...

Stress coping strategies among college

students: Associations with e-cigarettes

and physical activity.

Sarah Beth Lynch, MPH

University of Colorado-Denver

Melissa Napolitano, PhD

George Washington University, Milken Institute School of Public Health

Cassandra Stanton, PhD

Georgetown University; Westat

Background

➧ The use of e-cigarettes has increased exponentially

among young adults.

➧ In 2014, 21.6% of US adults between the ages of 18-24

years reported ever trying an e-cigarette.1

➧ Estimates of ever use of trying e-cig among college

students range from 4.9%2- 29%.3

2

Public Health Significance

➧ American Heart Association4 and American Lung

Association5 issued position statements asserting e-cigs

may prime young adults for nicotine addiction.

➧ Health consequences of e-cigarette smoking is under-

researched.4

3

What are e-cigarettes?

4

E-cigarettes and perceived stress

➧ Cigarette users report greater perceived stress than

non-cigarette users.6,7

➧ The perceived novelty and accessibility of e-cigs8 may

make e-cigs a convenient way for college students to

manage stress.

➧ Transition from high school to college may be stressful.9

➧ Students may adapt to stress using readily available

coping strategies, including engaging in unhealthy

lifestyle choices (e.g. tobacco and/or nicotine use,

sedentary behavior). 5

Research Question

➧ Do ever e-cigarette smokers and never

e-cigarette smokers report different levels

of:

Perceived Stress (PSS)

Physical Activity

➧IPAQ and 1 question about using

physical activity to manage stress

Sedentary Activities to manage stress

➧1 item from APA Stress in America

Survey 6

Methods

➧ College students (N=230) completed an anonymous

online survey.

➧ Recruited through social media and classroom

announcements.

➧ Separated into two groups based on yes/no response to

following question:

“Have you ever tried an e-cigarette, even one or two

puffs?”

7

Sample

8

Ever tried e-cigs Never tried e-cigs

37% (n=84) 63% (n=146)

BMI 22.5 23.3

AGE 20.9 years 21.1 years

% FEMALE 58.3% (n=49)* 74.0% (n=108)*

TRIED CIGARETTES 43.9% (n=54) 56.1% (n=69)

*X2 (1,230)=7.03; p <.05

Results: Perceived Stress

➧ Ever e-cigarette users reported significantly lower levels

of perceived stress than never e-cigarette users user

[F(1,228) =3.7; p<.05) 9

28.1 26.40

5

10

15

20

25

30

35

40

Ever tried e-cigarettes Never tried e-cigarettes

PSS Score

Results: Sedentary Stress Coping

➧ Ever e-cigarette users were more likely than never e-

cigarette users to utilize sedentary behaviors as a way to

manage stress [X2 (1,230)=5.08; p <.05)].

10

No33%

Yes67%

Never tried e-cigarettes

No19%

Yes81%

Ever tried e-cigarettes

“Do you watch

TV/Netflix/surf the

internet to relieve or

manage stress?”

Results: Physical Activity to Manage Stress

➧ No significant difference between groups with regards to

utilizing physical activity as a way to manage stress [X2

(1,230)=1.36; p >.05)].11

No41%Yes

59%

Never tried e-cigarettes

No33%

Yes67%

Ever tried e-cigarettes

“Do you exercise, walk or play sports to relieve or manage stress? ”

Results: Minutes of Moderate Physical

Activity/Week

➧ No significant difference

in minutes of physical

activity per week

between e-cig users

and non-users

[F(1,228)=0.3, p >.05]

12

0

50

100

150

200

250

300

Never tried e-cigarettes Ever tried e-cigarettes

min

ute

s

Minutes of Moderate PA/Week

Summary

➧ College students who have ever tried an e-cigarette were

more likely than college students who never tried an e-

cigarette to report coping with stress with sedentary

activities.

➧ The sample size in this pilot study was relatively small;

future studies are needed to examine whether the

frequency of use (ever tried versus regular use) shows

different associations with stress management

13

Limitations

➧ Sample size

➧ Classification of “ever used e-cigarettes” and “never used

e-cigarettes”

Individuals who smoking e-cigarettes every day may

present different scores on the outcome measures

compared with someone experimenting or using

socially

14

Comments

➧ Ever e-cigarette users may adapt to stress with distraction

or quick fix coping strategy more than never e-cigarette

users.

➧ Methods of managing stress result in a variety of

behaviors that, over time, may influence health outcomes.

➧ Understanding differences in adaptive health behaviors

among college students may assist in the development of

primary prevention programs for young adults.

15

References

1. Centers for Disease Control and Prevention (2015). Data Briefs on e-cigarettes. Available at

http://www.cdc.gov/nchs/data/databriefs/db217.pdf

2. Stufin et al. (2013). Electronic cigarette use by college students. Drug and alcohol dependence, 131(3), 214-221.

3. Littlefield et al. (2016). Electronic Cigarette Use Among College Students: Links to Gender, Race/Ethnicity, Smoking,

and Heavy Drinking. Journal of American College Health.

4. Bhatnagar et al. (2014). Electronic cigarettes a policy statement from the American Heart

Association. Circulation, 130(16), 1418-1436.

5. American Lung Association. (2015). E-Cigarettes and Lung Health. Available at http://www.lung.org/stop-

smoking/smoking-facts/e-cigarettes-and-lung-health.html.

6. Magid, V., Colder, C. R., Stroud, L. R., Nichter, M., Nichter, M., & Members, T. E. R. N. (2009). Negative affect,

stress, and smoking in college students: Unique associations independent of alcohol and marijuana use. Addictive

behaviors, 34(11), 973-975.

7. Black, D. S., Sussman, S., Johnson, C. A., & Milam, J. (2012). Testing the indirect effect of trait mindfulness on

adolescent cigarette smoking through negative affect and perceived stress mediators. Journal of substance

use,17(5-6), 417-429.

8. Dutra, L. M., & Glantz, S. A. (2014). Electronic cigarettes and conventional cigarette use among US adolescents: a

cross-sectional study. JAMA pediatrics, 168(7), 610-617.

9. Arnett JJ. Emerging adulthood: A theory of development from the late teens through the twenties. American

Psychologist. 2000;55(5):469-480.16

Thank you!

•Dr. Krista Ranby

•Participants