Date of Award

Fall 10-27-2021

Degree Type


Degree Name

Master of Science (MS)


Respiratory Therapy

First Advisor

Douglas S. Gardenhire, EdD, RRT, RRT-NPS, FAARC

Second Advisor

Rachel E. Culbreth, PhD, MPH, RRT

Third Advisor

Ralph D. Zimmerman, PhD, RRT, RRT-NPS, FAARC


Background: There has been a substantial increase in the worldwide use and popularity of electronic cigarettes (e-cigarettes) in recent years, especially among youth. However, little is known about the differences in e-cigarette and tobacco-related harm perceptions among U.S. adolescents by smoking status, gender, and age. Therefore, this study sought to assess the prevalence of perceptions of tobacco-related harm among youth by smoking status (e-cigarette users, cigarette users, and non-users), gender, and age. This study also examined the association between the perceptions of peer-related e-cigarette and cigarette use with actual e-cigarette and cigarette use among youth. Method: Analyses were conducted using the 2020 National Youth Tobacco Survey. The National Youth Tobacco Survey is a nationally representative sample of middle school and high school students in the United States (n=14,531). This survey is also listed as one of the exempt studies for designation of non-human subject research for Georgia State University Research Administration. Data were analyzed using SPSS program version 28. Cross-tabulations and Chi-square tests were used to assess perceptions of harm of e-cigarettes and cigarettes by smoking status, gender, and age. Results: Approximately 45% of non-tobacco users believed that e-cigarettes are harmful, yet only 22% of cigarette and e-cigarette users believed that e-cigarettes are harmful. Additionally, 19% of non-e-cigarette users and 16% of non-cigarette users believed that the vapor from cigarettes is harmful, yet only 9% of the same group believed that the vapor from e-cigarettes is harmful. Moreover, Prevalence of high school students for harm perceptions of both cigarettes and e-cigarettes was consistently lower compared to middle school students. E-cigarette users were more likely to believe that ten out of every ten students in their grade use e-cigarettes (pConclusion: A lower prevalence of e-cigarette and cigarette users endorsed harmful perceptions of e-cigarette and cigarette use compared to non-users. Overall, e-cigarettes were perceived as less harmful compared to cigarettes among youth.


File Upload Confirmation