E-cigarette use susceptibility among Mexican adolescents: The roles of remote acculturation, parenting, and media use

• In Event: 1-019 - Implications of Remote Acculturation for Child and Youth Development in non-Western Contexts

Integrative Statement

As a result of RA, many adolescents in majority world countries such as Mexico emulate behaviors associated with US culture ( Ferguson et al., 2017), which can influence their tobacco use (Lorenzo-Blanco et al., 2017). Given Mexico’s proximity to and ongoing relations with the U.S. (Stepler & Brown, 2013), it is possible that globalization exposes adolescents in Mexico to e-cigarettes through media, contributing to Mexican adolescents’ willingness to try e-cigarettes. Adolescent e-cigarette use is increasing rapidly (Vogel, Ramo, & Rubinstein, 2018), and may lead to nicotine addiction, cigarette smoking, and changes in brain development (McIntire & Ludwig, 2015). The rapid increase in adolescent e-cigarette use may be due to media advertising that depicts celebrities using e-cigarettes (Grana et al., 2014). Adolescents in Mexico may be especially influenced by these positive e-cigarette media images. Although, e-cigarette importation, distribution, and advertising are prohibited in Mexico (Grana et al., 2014), the prevalence of adolescent e-cigarette trial (10%) and use (7%) in Mexico is comparable to that of the U.S. (11.9% and 3.5%, respectively) where e-cigarette regulations are more relaxed (Nicole, Snell, Morgan, & Andrew, 2017).

In this study, we investigated the hypothesis that RA (i.e., orientation to U.S. American and Mexican culture) influences media use, and by extension e-cigarette use susceptibility among adolescents in Mexico. Additionally, because parenting practices (Lorenzo-Blanco, Bares, & Delva, 2010) can relate directly with lower tobacco and media use (Samaha & Hawi, 2017), we also hypothesized direct associations of parenting practices and parental media restrictions with media use. Control variables included age, gender sensation seeking, family affluence, friend and family e-cigarette use, and adolescent smoking (see Figure 1 for conceptual model). The sample comprised adolescent students in Mexico (N=6004; 52.6% female; Mage=13.07 years), who had never tried e-cigarettes before. Participants completed a school-based survey that measured RA, parental media restrictions, maternal parenting practices, media use, and e-cigarette use susceptibility.

As shown in Figure 2, structural equation analyses indicated that Mexican cultural orientation (β=-.13) and parental media restrictions (β=-.12) was associated with lower media use, and U.S. American cultural orientation was associated with higher media use (β=.61). Media use, in turn, was associated with higher e-cigarette use susceptibility (β=.12). Moreover, mothers' parenting practices were directly associated with lower e-cigarette use susceptibility (β=-.07). Lastly, media use mediated the associations from Mexican cultural orientation (β=-.02, p<. 001, 95% CI [-0.021, -0.010]), U.S. cultural orientation (β=.08, p < .001, 95% CI [0.052, 0.098]), parenting practices (β=-.07, p<.05, 95% CI [-0.005, 0.001]), and parental media restrictions (β=-.02, p< .001, 95% CI [-0.020, -0.010]) to greater e-cigarette use susceptibility.

Findings suggest an indirect pathway from RA to E-cigarette use susceptibility via adolescent media use. Preventive interventions to reduce Mexican adolescents’ willingness to try out e-cigarettes may benefit from efforts to reduce adolescent media use, or encourage parents' monitoring of adolescents’ media use. Moreover, such interventions may be especially beneficial for adolescents with high levels of RA to U.S. culture, which emerged in this study as a potential risk factor. We discuss directions for future research.

Authors

• Elma Elma Lorenzo-Blanco, The University of Texas at Austin
  Presenting Author

• James Thrasher, University of South Carolina, Arnold School of Public Health
  Non-Presenting Author