Perceptions of cigarettes and e-cigarettes: does health literacy matter?

The impact of electronic health literacy on emotional management ability among college students: the mediating roles of peer relationships and exercise self-efficacy

OBJECTIVE

This study aims to explore electronic health literacy's impact on college students' emotional management ability and analyze the chained mediating effects of peer relationships and exercise self-efficacy.

METHODS

The study used stratified, cluster, and staged sampling methods to collect demographic information. Electronic health literacy, peer relationships, exercise self-efficacy, and emotional management ability data were collected among college students using the Questionnaire Star software. A total of 30,105 valid questionnaires were obtained, with a valid response rate of 98.7%. Using Process Model 6, investigated how electronic health literacy sequentially influences emotional management ability through mediators such as peer relationships and exercise self-efficacy.

RESULTS

There was a significant positive correlation between electronic health literacy and emotional management ability (r = 0.496, P < 0.01), between electronic health literacy and peer relationships (r = 0.226, P < 0.01), and between electronic health literacy and exercise self-efficacy (r = 0.180, P < 0.01). Peer relationships were significantly positively correlated with exercise self-efficacy (r = 0.142, P < 0.01) and emotional management ability (r = 0.396, P < 0.01). Exercise self-efficacy was significantly positively correlated with emotional management ability (r = 0.339, P < 0.01). Electronic health literacy significantly and positively predicted emotional management ability (β = 0.254, P < 0.001). There was a mediating effect of peer relationships between electronic health literacy and emotional management ability, accounting for 58.2% of the impact, 95%CI: [0.036,0.042]. Exercise self-efficacy also mediated the relationship between electronic health literacy and emotional management ability, accounting for 61.5% of the effect, 95%CI: [0.022,0.027]. Moreover, a chained mediating effect of peer relationships and exercise self-efficacy was observed between electronic health literacy and emotional management ability, accounting for 17.1% of the effect, 95%CI: [0.004,0.005].

CONCLUSION

Electronic health literacy among college students can positively predict emotional management ability. Both peer relationships and exercise self-efficacy play a chained mediating role between electronic health literacy and emotional management ability.

The association between health literacy and e-cigarette use: evidence from Zhejiang, China

Objectives

The worldwide popularity of electronic cigarettes (ECIG) is becoming a public health concern. Compared to conventional cigarettes (CIG), the harm caused by ECIG is more insidious. Studies have shown that lower health literacy (HL) is associated with CIG use; however, the relationship between HL and ECIG use remains controversial. Because ECIG emerged more recently than CIG, there are fewer relevant studies, and the sample populations and evaluation methods of HL in existing studies differ. This study conducted a large-sample survey to examine the relationship between HL and ECIG use.

Methods

As part of the 2022 China Health Literacy Survey, a total of 60,998 valid questionnaires were collected from September to November in 2022 using a stratified multistage probability proportional to the population size sampling frame. Chi-square tests and multinomial logistic regression was used to analyze the relationship between HL and ECIG use. Some demographic variables were included as covariates in the analysis.

Results

The study showed that the average HL score and the HL level of Zhejiang residents in 2022 were 42.8 and 30.8%, respectively. The prevalence of CIG and ECIG was 19.7 and 1.0%, respectively; 19% of participants exclusively used CIG, while only 0.3% of participants used ECIG exclusively; dual users accounted for 0.6%. After adjusting for covariates, adequate HL was associated with lower odds of ECIG-exclusive use (odds ratio [OR] = 0.452, p < 0.001), CIG-exclusive use (OR = 0.833, p < 0.001), and dual use (OR = 0.632, p < 0.001). Young age, male sex, unmarried status, high-income status, and absence of chronic disease were also associated with ECIG use.

Conclusion

HL was a protective factor against both patterns of ECIG use, especially ECIG-exclusive use. Health policymakers and public health practitioners should consider HL as a potential measure for ECIG control.

Health Literacy and Smoking Habits Among a Sample of Jordanian University Students

Limited health literacy is a significant predictor of engaging in unhealthy behaviors. However, the literature regarding the association between health literacy and smoking in university students is very limited. Thus, this study was conducted to examine the association between university students' health literacy and smoking habits. A cross-sectional design was used. A sample of university students (N = 327) was recruited to conduct this study. Data collection was performed using a demographics questionnaire and the health literacy questionnaire. AMOS was used to conduct data analysis using structural equation modeling analysis with maximum likelihood estimation. Different versions of the structural model were compared and evaluated based on specific fit indices criteria. The results showed that 30% of the participants were current smokers. Smoking cigarettes was the most common type of smoking in this study, and 23.1% of the participants were current users of two or more types of smoking (e.g., cigarettes and hookah). The structural model with three latent variables (health literacy, smoking status and type, and smoking frequency and duration) was the one that best fit the data; the model fit indices were X² = 305.84, df = 102, p < .001; RMSEA = .068; CFI = .95; CMIN/df = 2.51; TLI = .929; and AIC = 355.75. A single standard deviation increase of health literacy causes .38 decrease in smoking status and type and .13 decrease of smoking frequency and duration. The results showed that health literacy is negatively associated with smoking in a sample of Jordanian university students.

Vaping Media Literacy, Harm Perception, and Susceptibility of E-Cigarette Use Among Youth

INTRODUCTION

Exposure to E-cigarette marketing and media advertisements is prevalent among adolescents. A validated vaping media literacy scale is needed to inform effective vaping prevention programs.

METHODS

A 6-item vaping media literacy scale was adapted from validated smoking and general media literacy scales with an emphasis on marketing influences. A school-based survey (N=856) was conducted to assess the reliability of vaping media literacy and 3 subscales (i.e., authors and audiences [vaping Authors and Audiences], messages and meanings [vaping Messages and Meanings], and representation and reality [vaping Representation and Reality]). Multivariable logistic regression models were performed to examine the associations of vaping media literacy with perceived harmfulness of E-cigarette use and susceptibility to use E-cigarettes. Analyses were conducted in 2021.

RESULTS

The mean vaping media literacy among students was 2.6 (range=0-6). There were significant disparities with lower vaping media literacy among middle-school (versus high-school, p=0.03) students, males (versus females, p=0.003), and racial/ethnic minority students (Blacks, Hispanics, others versus Whites, p=0.0009). A higher vaping media literacy was significantly associated with increased perceived harmfulness of E-cigarette use (AOR=1.2; 95% CI=1.1, 1.2; p<0.0001). All subscales were also associated with E-cigarette harm perception. Among never E-cigarette users, students with a higher (versus those with a lower) vaping media literacy had lower susceptibility to initiating E-cigarettes (AOR=0.90; 95% CI=0.83, 0.97; p=0.005). Both vaping Messages and Meanings and vaping Representation and Reality subscales were adversely associated with susceptibility to vaping.

CONCLUSIONS

The vaping media literacy scale may gauge the influence of E-cigarette marketing on adolescents with high reliability and validity. Racial minorities, younger adolescents, and males appear relatively vulnerable to vaping marketing influence. Efforts to increase vaping media literacy are needed to curb youth E-cigarette use.