Young adult e-cigarette users: perceptions of stress, body image, and weight control

  • Melissa A. Napolitano
  • Sarah Beth Lynch
  • Cassandra A. Stanton
Original Article



With the rise in electronic cigarette (ENDS) use among US young adults, more research is needed on expectations for use and perceptions related to body image, weight control, and stress relief.


College students (N = 230; modal age 21 years; 68% female) completed an online survey assessing cigarette smoking and ENDS, dieting and body image, perceptions about flavors, stress, weight gain prevention, and appetite regulation.

Sample characteristics

Dual use (cigarette and ENDS) was reported by n = 69 (30.0%). Exclusive cigarette smoking was endorsed by n = 53 (23%) with exclusive ENDS use reported by n = 15 (6.5%). Ninety-three participants (40.5%) reported not using either product.


Among those using ENDS, < 33% reported using as a stress management tool, < 15% reported using ENDS to control appetite, and > 70% reported using cartridges that tasked like sweets. There was a positive correlation between dieting behaviors and body concern, suggesting those who reported higher use of ENDS for weight and appetite regulation also had higher pathological eating scores and concern over body shape and size.


Prevention and education related to weight, body image, and tobacco are needed to address misperceptions of tobacco products.

Level of evidence

Level V, cross-sectional descriptive study.


Electronic cigarette Weight control Body dissatisfaction Body image Flavors Young adults Smoking 



A portion of these results were presented at the Society of Behavioral Medicine Annual Meeting in 2015. The authors would like to thank Dr. Sharon Hayes for her assistance with recruitment, as well as Katrina Hufnagel and Madeline Kirch. The authors would also like to thank Chelsey DuBois for her help with manuscript submission.

Compliance with ethical standards

Ethical approval

All procedures performed were in accordance with the ethical standards of The George Washington University and the University of Colorado-Denver Institutional Review Boards (IRBs) and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

Informed consent

The protocol was deemed exempt by the IRBs; therefore, signed informed consent was not required. There was a process by which subjects viewed an electronic information sheet prior to beginning the questionnaires and then confirmed their agreement to participate. Contact information was readily available for the participant to ask any questions prior to completing the survey.

Conflict of interest

The authors have no conflicts of interest to disclose.


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Copyright information

© Springer Nature Switzerland AG 2018

Authors and Affiliations

  1. 1.Department of Prevention and Community HealthThe George Washington University Milken Institute School of Public HealthWashingtonUSA
  2. 2.Department of Exercise and Nutrition SciencesThe George Washington University Milken Institute School of Public HealthWashingtonUSA
  3. 3.University of Texas at Austin School of NursingAustinUSA
  4. 4.Westat Cancer Prevention and Control ProgramGeorgetown University Medical CenterRockvilleUSA

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