Poor body esteem drives young women to vape

Young women with weak body esteem are more likely to use e-cigarettes for weight control reasons, according to a new study.

“This may be the first study to prospectively demonstrate that weight-control outcome expectancies are a unique predictor of e-cigarette use among young adults,” said researchers. “Our findings further suggest that young adult struggling with negative body esteem may be particularly vulnerable to using e-cigarettes for weight control motives.”

In 2,327 young adults (mean age, 21.2±2.2 years; 54 percent female), males were more likely to report past 30-day e-cigarette use while females tended to have higher average body mass index (BMI). Smoking conventional, combustible cigarettes was comparable between sexes. [Nicotine Tob Res 2020;doi:10.1093/ntr/ntaa009]

In female participants, weight concern and physical condition were set as body esteem indicators. Those with higher BMI had poorer self-perceptions of their physical condition and, in turn, had greater weight control outcome expectancies and showed stronger cigarette smoking habits.

Similar patterns of correlation were found with weight concern, which was more common in females with higher BMI and correlated with higher expectancies of weight control. Weight concern was also associated with more frequent cigarette smoking and use of the electronic nicotine delivery device.

Three body esteem indicators were determined for males: upper body strength, physical attractiveness and physical condition. None were found to be correlated with expectancies of weight control outcomes, cigarette smoking or device use. However, males who had higher weight control expectancies tended to smoke and use e-cigarettes more.

Meditational analysis with structural equation models confirmed these findings. In males, for instance, the researchers found no direct or indirect links between baseline body esteem and the use of e-cigarettes in the past 30 days.

However, the effect of weight control expectancies did remain, with men who had stronger expectancies at the 6-month follow-up showing greater device use another 6 months later. Conversely, men with baseline cigarette and e-cigarette use tended to have higher weight control expectancies at 6 months and, in turn, stronger use habits at 1 year.

In women, low body esteem continued to be a predictor of e-cigarette use, with higher weight control expectancy as a mediating factor.

“The lack of association between negative body esteem and future e-cigarette use among men may be explained in terms of how body esteem is manifested for men versus women,” the researchers explained, pointing out that men may prefer developing a muscular body, while women opt for a slim frame.

“[T]his may be a reason why body esteem is associated with weight control outcome expectancies for e-cigarette use among women but not men,” they added. “The current findings draw attention to women struggling with body esteem as a vulnerable group potentially at high risk for e-cigarette use.”

More importantly, the present findings hold important implications for prevention and intervention programmes, the researchers said. Such efforts may include campaigns to correct misconceptions about the effects of e-cigarettes on weight management to help these individuals find healthier strategies of weight control.