Applying Social Network Theory to Vaping in High School: Implications for Person-Centered Intervention

Background: Peer influence on risky behavior is particularly potent in adolescence and varies by gender. Smoking prevention programs focused on peer-group leaders have shown great promise, and a social influence model has proven effective in understanding adult smoking networks but has not been applied to adolescent vaping until 2023. This work aims to apply a social influence model to analyze vaping by gender in a high school network. Methods: A high school’s student body was emailed an online survey asking for gender, age, grade level, vape status, and the names of three friends. Custom Java and MATLAB scripts were written to create a directed graph, compute centrality measures, and perform Fisher’s exact tests to compare centrality measures by demographic variables and vape status. Results: Of 192 students in the school, 102 students responded. Students who vape were in closer-knit friend groups than students who do not vape (p < .05). Compared to males who vape, females who vape had more social ties to other students who vape, exhibiting greater homophily (p < .01). Compared to females who do not vape, females who vape were in closer-knit friend groups (p < .05) and had more ties to other students who vape (p < .01). Conclusion: Differences in vaping by social connectedness and gender necessitate school and state policies incorporating the social aspect of vaping in public health initiatives. Large-scale research should determine if trends can be generalized across student bodies, and more granular studies should investigate differences in motivations and social influence by demographic variables to individualize cessation strategies.

背景：风险行为中的同伴影响在青少年期尤为显著，且存在性别差异。以同伴群体领袖为核心的控烟项目已展现出良好的应用前景，而社会影响模型（social influence model）在解析成人吸烟社交网络方面已被证实有效，但直至2023年才被应用于青少年电子烟吸食行为（vaping）的相关研究。本研究旨在应用该社会影响模型，对某高中社交网络中的青少年电子烟吸食行为按性别展开分析。方法：本研究向某高中全体学生发送电子邮件，邀请其参与线上调查，调查内容涵盖性别、年龄、年级、电子烟吸食状态以及三名好友的姓名。研究编写了定制化的Java与MATLAB脚本，用于构建有向图、计算中心性指标，并开展费希尔精确检验（Fisher’s exact tests），以基于人口统计学变量与电子烟吸食状态对比中心性指标的差异。结果：该校共有192名学生，最终回收有效问卷102份。电子烟吸食者所在的好友群组紧密程度显著高于非吸食者（p<0.05）。与男性电子烟吸食者相比，女性吸食者与其他电子烟吸食者拥有更多社交联结，表现出更强的同质性偏好（homophily，p<0.01）。与非吸食的女性学生相比，吸食电子烟的女性所在好友群组更为紧密（p<0.05），且与其他电子烟吸食者的社交联结更多（p<0.01）。结论：基于社交联结与性别差异的电子烟吸食行为差异，要求学校与州级政策将电子烟吸食行为的社会层面纳入公共卫生举措之中。未来需开展大规模研究以验证该趋势是否可推广至其他学生群体，同时开展更精细化的研究，基于人口统计学变量探究吸食动机与社会影响的差异，从而制定个性化的戒断策略。