Exploring the Relationships Between Social Influence, Vaping Behaviors, and Susceptibility Across Grade Levels in Kentucky

Purpose: This study explored the relationships between social influence, vaping behavior, and susceptibility across different grade levels. Design: The study design was cross-sectional. Data were collected from middle and high school students who voluntarily participated between September 2022 and April 2023. Sample: A convenience sample of students in 6^th to 12^th grades in Kentucky (N = 4677). Measures: Demographic information, including age, grade level, school location, and race/ethnicity, was collected. The outcome variables included social influence, susceptibility, and vaping behavior. Analysis: Logistic regression analysis was used to explore the relationships between social influence, vaping behavior, and susceptibility. Results: The analysis showed significant differences in vaping behaviors and susceptibility between middle and high school students, with high school students having higher odds of vaping (OR = 1.58, 95% CI = [1.15, 2.17]). However, after adjusting for covariates, grade level differences were no longer significant (aOR = 1.01, 95% CI = [0.67, 1.51]). The adjusted model showed that youth with 1 vaping friend were 3 times more likely to try vaping (aOR = 2.83, 95% CI = [1.91, 4.22]), while those with 5 vaping friends were over 22 times more likely (aOR = 22.30, 95% CI = [13.34, 37.29]). Conclusion: The results emphasize the need for primary interventions that address social influences on youth vaping initiation and continued use among students across middle and high school grade levels.