All ETDs from UAB

Advisory Committee Chair

Peter S Hendricks

Advisory Committee Members

Adam M Leventhal

Eric W Ford

Donald H Lein

Gregory Pavela

Michael J Wells

Document Type


Date of Award


Degree Name by School

Doctor of Philosophy (PhD) School of Health Professions


Asthma is associated with a higher likelihood of electronic cigarette (e-cigarette) use, which may increase the risk of pulmonary complications. Therefore, we sought to identify factors that influence e-cigarette use that may inform future behavior interventions targeting e-cigarette use prevention. In this dissertation, we used mediation and moderation to model the relationship of health beliefs, psychosocial and behavioral factors that may affect the relationship between e-cigarette use and asthma. We used national samples from public datasets, and a clinical sample recruited from healthcare facilities in Alabama. The results of this study are reported in three different papers. In the first study, we analyzed public datasets from youth and young adults in the United States with the purpose to evaluate the association between self-reported asthma, mental health functioning, tobacco smoking, alcohol use, and e-cigarette use with a focus on mental health and tobacco smoking as potential mediators and alcohol use as a potential moderator in the relationship between asthma and e-cigarette use among youth and young adults. The results showed that mental health was a mediator that increased the use of e-cigarettes among young adults with self-reported asthma; however, current alcohol use was not a moderator associated with the use of e-cigarettes by youth and young adults with self-reported asthma. The second study used a clinical sample of youth and young adults with asthma to assess the mediation effects of perceived e-cigarette outcome expectancies and perceived e-cigarette resistance self-efficacy on e-cigarette use and asthma. The results revealed that positive outcome expectancies and resistance self-efficacy mediated the relationship between asthma and e-cigarettes use among youth and young adults. In the third paper, we assessed the mediation effects of anxiety, depression, and impulsivity, and the moderation effects of alcohol and cannabis use. The results were not supported by our hypotheses as the mediators of interests were not significant predictors of asthma with respect to e-cigarette use. However, we found that cannabis use was a moderator associated with e-cigarette use among youth and young adults with asthma. Future studies should explore health belief, psychosocial and health behavior factors, and e-cigarette use among people with active asthma in longitudinal investigations with a larger sample size. These researchers should further investigate the factors that we found affecting the relationship between asthma and young adults such as perceived outcome expectancy, toward e-cigarette use, resistance self-efficacy, and susceptibility to e-cigarette use, as well as mental health disorders, and substance abuse. A better understanding of these factors could lead to tailored interventions that prevent and treat e-cigarette use among people with asthma.



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