Date of Award

Summer 8-2022

Document Type


Degree Name

Doctor of Philosophy (PhD)




Virginia Consortium Program in Clinical Psychology

Committee Director

Paul T. Harrell

Committee Member

Kelli England

Committee Member

Abby Braitman

Committee Member

Leah Floyd


African Americans experience higher mortality from lung cancer and other smoking-related diseases than Caucasian Americans (Kochanek et al., 2016) despite engaging in cigarette and e-cigarette use significantly less or at comparable rates to other racial groups (CDC, 2015; Schoeborn, 2013). During adolescence, smoking prevalence is lower among African Americans than Caucasian Americans, but there is a “cross-over effect” whereby smoking rates become similar later in adulthood (Belgrave et al, 2010). The mechanisms driving this effect are poorly understood. Thus, examining motivating factors for tobacco use, such as outcome expectancies and emotion regulation, may be especially illuminating for young adult African Americans and Caucasian Americans.

Outcome expectancies are robust correlates of many tobacco behaviors including cigarette smoking initiation (Doran, Schweizer, & Myers, 2011), smoking maintenance (Juliano & Brandon, 2004), e-cigarette initiation (e.g., Hendricks et al., 2015), and switching from combustible cigarettes to e-cigarettes (Harrell et al., 2015). Emotion regulation is associated with cigarette smoking recency (Adams et al. 2012) and affect-regulatory smoking expectancies (Johnson et al. 2008). However, there is little research examining how tobacco use and these risk factors associated with tobacco use vary by racial/ethnic group.

The proposed project involved secondary analyses of a dataset funded by the National Cancer Institute that includes students from a Historically Black College or University (HBCU) and a community college. Questions regarding tobacco use, outcome expectancies, and emotion dysregulation were included.

African Americans reported lower e-cigarette use. However, they did not report higher little cigar use than Caucasian Americans. As expected, current e-cigarette users reported significantly higher positive reinforcement, negative reinforcement, and weight control beliefs, while non-users reported higher negative consequences about e-cigarette use. Caucasian Americans had significantly higher negative consequences and positive reinforcement outcome expectancies, as well as higher DERS goals, strategies, and nonacceptance scores than African Americans which was partially in line with hypothesis. Difficulties in goal setting and higher impulsivity were significant predictors of past-six-month cigar use. Lastly, there was a significant mediation between race and current e-cigarette use via outcome expectancies. Findings indicate that culturally specific interventions for e-cigarette prevention and cessation may be helpful.


The VIRGINIA CONSORTIUM PROGRAM IN CLINICAL PSYCHOLOGY is a joint program of Eastern Virginia Medical School, Norfolk State University, and Old Dominion University.


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