e-Cigarettes in College-Age Students: Roles of the Nurse Practitioner

Published:September 17, 2021DOI:https://doi.org/10.1016/j.nurpra.2021.08.007


      • Nurse practitioners are uniquely prepared to provide primary care to prevent the use of vaping devices.
      • A low grade point average and Greek life were significantly related to increased vaping practices.
      • College students are generationally chill and do not judge peers’ vaping behaviors.


      The aims of this study were to assess practices and identify strategies to reduce e-cigarette use among college students. Using a mixed methods design, an online survey assessed e-cigarette perceptions and usage, and focus groups were used to conduct in-depth assessments. Grade point average and Greek life were significantly related to e-cigarette practices. Content analysis yielded 5 main categories: safer than smoking, it’s cool in high school, easily accessible, generationally chill, and quitting because of consequences. Nurse practitioners, who often provide primary care to this age group, should provide evidence-based educational initiatives and inform college policies to deter e-cigarette use.


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        • Schulenberg J.E.
        • Johnston L.
        • O’Malley P.M.
        • Bachman J.G.
        • Miech R.A.
        • Patrick M.E.
        Monitoring the Future National Survey Results on Drug Use, 1975-2019: Volume II, College Students and Adults Ages 19-60.
        Institute for Social Research, Ann Arbor, MI2020
        • Kenne D.
        • Fischbein R.
        • Tan A.
        • Banks M.
        The use of substances other than nicotine in electronic cigarettes among college students.
        Subst Abuse. 2017; 11 (117822187733736. https://doi.org/10.1177.117822187733736)
        • Soneji S.
        • Barrington-Trimis J.
        • Wills T.
        • et al.
        Association between initial use of e-cigarettes and subsequent cigarette smoking among adolescents and young adults: a systematic review and meta-analysis.
        JAMA Pediatr. 2017; 171: 788-797https://doi.org/10.1001/jamajpediatrics.2017.1488
        • American Association of Nurse Practitioners
        NP fact sheet.
        (2020. Accessed March 15, 2021)
        • Wang T.
        • Neff L.
        • Park-Lee E.
        • Ren C.
        • Cullen K.
        • King B.
        E-cigarette use among middle and high school students – United States, 2020.
        MMWR Morb Mortal Wkly Rep. 2020; 69: 1310-1312https://doi.org/10.15585/mmwr.mm6937e1
        • Katz S.
        • Erkinnen M.
        • Lindgre B.
        • Hatsukami D.
        Beliefs about e-cigarettes: a focus group study with college students.
        Am J Health Behav. 2019; 43: 76-87https://doi.org/10.5993/AJHB.43.1.7
        • Simerson D.
        What the advanced practice nurse in the emergency department needs to know about the health risks and hazards of electronic cigarette use by youth.
        Adv Emerg Nurs J. 2018; 40: 36-44https://doi.org/10.1097/TME.0000000000000176
        • Huey S.
        • Granitto M.
        Smoke screen: the teen vaping epidemic uncovers a new concerning addiction.
        J Am Assoc Nurse Pract. 2020; 32: 293-298https://doi.org/10.1097/JXX.0000000000000234
        • Prochaska J.O.
        • DiClemente C.C.
        • Norcross J.C.
        In search of how people change: applications to addictive behaviors.
        Am Psychol. 1992; 47: 1102-1114https://doi.org/10.1037//0003-066x.47.9.1102
        • Martinasek M.
        • Tamulevicius N.
        • Gibson-Young L.
        • et al.
        Predictors of vaping behavior change in young adults using the transtheoretical model: a multi-country study.
        Tob Use Insights. 2021; 14: 1-5
        • American College Health Association
        American College Health Association-National College Health Assessment II Survey. 2019.
        (Accessed March 15, 2021)
        • Kessler T.A.
        • Rayman L.
        Undergraduate student-faculty collaborative research: a pilot study exploring care of a family member with dementia.
        J Nurs Educ Pract. 2021; 11: 17-23https://doi.org/10.5430/jnep.v11n3p17
        • Elo S.
        • Kyngäs H.
        The qualitative content analysis process.
        J Adv Nurs. 2007; 62: 107-115https://doi.org/10.1111/j.1365-2648.2007.04569.x
        • Lindgrena B.M.
        • Lundmana B.
        • Graneheima U.H.
        Abstraction and interpretation during the qualitative content analysis process.
        Int J Nurs Stud. 2020; 108: 1-6https://doi.org/10.1016/j.ijnurstu.2020.103632
        • Wallace L.
        • Roche M.
        Vaping in context: links among e-cigarette use, social status, and peer influence for college students.
        J Alcohol Drug Educ. 2018; 48: 36-53https://doi.org/10.1177/00472379I8807706
        • Qasim H.
        • Karim Z.
        • Rivera J.
        • Khasawneh F.
        • Alshbool F.
        Impact of electronic cigarettes on the cardiovascular system.
        J Am Heart Assoc. 2017; 6: 1-14https://doi.org/10.1161/JAHA.117.006353
        • American College Health Association
        Addressing e-cigarette use and vaping on college and university campuses. 2021.
        (Accessed March 15, 2021)
        • Hicks R.
        • Dinkel S.
        The hidden gems in student health centers.
        J Am Assoc Nurse Pract. 2016; 28: 178-180https://doi.org/10.1002/2327-6924.12364
        • American College Health Association
        Undergraduate student reference group data report spring 2021.
        (Accessed August 3, 2021)
        • Gentzke A.
        • Creamer M.
        • Cullen K.
        • et al.
        Vital signs: tobacco product use among middle and high school students-United States 2011-2018.
        MMWR Morb Mortal Wkly Rep. 2019; 68: 157-164
        • Saeed A.A.
        • Cunningham K.
        • Bloch R.M.
        Depression and anxiety disorders: benefits of exercise, yoga, and meditation.
        Am Fam Physician. 2019; 99: 620-651
        • Dvorsky M.R.
        • Langberg J.M.
        Cigarette and e-cigarette use and social perceptions over the transition to college: the role of ADHD symptoms.
        Psychol Addict Behav. 2019; 33: 318-330https://doi.org/10.1037/adb0000450


      Lynette Rayman, DNP, RN, CNE, is Assistant Dean of Undergraduate Nursing and Assistant Professor at Valparaiso University in Valparaiso, IN, and can be contacted at [email protected] .


      Theresa A. Kessler, PhD, RN, ACNS-BC, CNE, FAAN, is Professor and Kreft Endowed Chair for the Advancement of Nursing Science at Valparaiso University.