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Objective: The present study developed a measure assessing the emotional responses, "Displacement Imposition," of cigarette and e-cigarette users on a college campus with a smoking/vaping ban. It also examined the relationship between "Displacement Imposition" and readiness to quit smoking/ vaping, and how this relationship differed between cigarette and e-cigarette users. Participants: Participants (N=297) were from a large, Midwestern university. Methods: Participants completed online questionnaires assessing demographics, cigarette and e-cigarette use, "Displacement Imposition," and readiness to quit. Results: All six "Displacement Imposition" items loaded onto a single factor. A significant interaction emerged between "Displacement Imposition" and product use in predicting readiness to quit. At high levels of "Displacement Imposition," cigarette users were less ready to quit than e-cigarette users. Conclusions: Findings suggest restrictions imposed on cigarette and e-cigarette users were associated with reduced readiness to quit. Findings inform tobacco control policies as tobacco denormalization may increase the burden placed on tobacco users.

The purpose of this study was to investigate the association between unrealistic optimism (UO) and risky sexual behavior (RSB) and related consequences in a college student sample. Participants believed they had significantly lower "personal" risk of engagement in alcohol-related sexual activity, unintended pregnancy, and STIs than the average college student ("ps" < 0.01). Compared to national data, participants significantly underestimated likelihood of HPV and sexual engagement with four or more partners in the next year ("ps" < 0.01). Findings support evidence of UO relating to RSB-related consequences, indicating need for improvements in sexual health education and intervention.

Objective: Research suggests college students rate some alcohol-related consequences less negatively than others, yet it is unclear how or when these differences in perception develop. The current study compared college students' subjective evaluations of alcohol-related consequences that they had and had not experienced in order to test the hypothesis that students become desensitized to the consequences they experience. Participants: Participants were 269 undergraduate students enrolled at a large, public, Midwestern university. Methods: Participants completed measures of drinking behaviors, consequences experienced, and subjective evaluations of consequences via an online survey. Results: Participants rated the consequences they had personally experienced more positively than those they had not experienced. Similarly, individuals who reported experiencing consequences rated them as significantly more positive than those who had not experienced the same consequences. Conclusions: Experience with consequences is associated with more positive evaluations of those consequences. Therefore, it may be important to consider individuals' experiences with, and evaluations of, alcohol-related consequences in college student drinking interventions.

The purpose of this study was to develop a new measure of incidental behaviors that put college students at increased risk of legal consequences while using alcohol, the Legal Risk Behaviors while using Alcohol (LRBA) scale. Two hundred and twenty one college students who used alcohol were recruited to complete an online study about their use of alcohol, specific behaviors engaged in while using alcohol, and associated consequences. Analyses revealed that the 19-item LRBA consisted of three factors--"Risky Behaviors," "Protective Behaviors," and "Private Settings." Analyses suggested that the LRBA had adequate test-retest reliability and internal consistency. Initial results indicate that the LRBA may be a useful measure to help us better understand what behaviors college student engage in that increase their risk for experiencing a legal encounter. (Contains 2 tables.)

ObjectiveThe current study aimed to inform future interventions for heavy alcohol use and problems among college students by examining the utility of normative perceptions and coping strategies in predicting alcohol use among student service members/Veterans (SSM/Vs).MethodsSSM/Vs and civilian students (N=319) at a large university in the Southern Plains completed self-report measures of demographics, alcohol use and related behaviors, and coping strategies.ResultsBoth SSM/Vs and civilian students significantly overestimated the typical weekly drinking quantities and frequencies of same-sex students on campus. Among SSM/Vs, normative perceptions of typical student (not military-specific) drinking and substance-related coping strategies significantly predicted drinks consumed per week, while substance-related coping predicted alcohol-related consequences.ConclusionsDespite the theoretical importance of similarity to normative referents, military-specific norms did not significantly improve the prediction of SSM/Vs' personal drinking behavior. Moreover, neither typical student nor military-specific norms predicted alcohol-related consequences among SSM/Vs after accounting for substance-related coping strategies. Future research may examine the efficacy of descriptive normative feedback and the importance of military-specific norms in alcohol interventions for SSM/Vs.

Sexual Strategies Theory suggests people fall on a continuum between having short-term mating orientation (STMO) and long-term mating orientation. One way STMO individuals signal mating goals is via risky drinking. The current study therefore aims to investigate drinks per week (DPW) as a mediator between STMO and risky sexual behavior (RSB), with gender as a moderator between STMO and DPW. Undergraduate students (N = 300) from a Midwestern university during Fall 2019. Participants completed questionnaires assessing STMO, DPW, and RSB frequency. A moderated-mediation model indicated DPW significantly mediated the relationship between STMO and RSB. Positive associations were found among all three variables. Gender was not a moderator between STMO and DPW. Mating orientation was a correlate of alcohol use and RSB for women and men, contributing to the literature identifying STMO as an indicator of those in need of substance use and RSB intervention. [ABSTRACT FROM AUTHOR]

The primary aim of the current study is to determine the incremental efficacy of adding a novel values component to a personalized feedback intervention for young adult drinking. Undergraduate students (N = 254) were randomized to receive either traditional, traditional with values assessment, or values enhanced feedback. Results showed significant decreases in drinks per week (p <.01) and alcohol-related consequences (p <.05) across all feedback conditions. Further research is needed to determine whether using values-based feedback could enhance intervention effects and how best to incorporate feedback in a way that is feasible and acceptable to recipients. [ABSTRACT FROM AUTHOR]

Poor sleep health is associated with numerous health concerns, and sleep problems are exacerbated by cigarette smoking. Although rates of traditional tobacco use are declining, rates of electronic cigarette (e‐cigarette) use are comparatively high and growing. Given that nicotine is a primary mechanism by which smoking negatively impacts sleep health, e‐cigarette use may also be linked to poor sleep health; however, no research has investigated this association. Participants were 1,664 college students, 40.9% of whom reported ever trying or currently using an e‐cigarette. Questionnaires assessed demographic information, sleep health and e‐cigarette use status and patterns. All measures were completed remotely via a secure online survey. Analysis of covariance was used to compare the sleep health of daily/non‐daily e‐cigarette users to (a) non‐users and (b) users of combustible cigarettes. Gender and drinks per week were included as covariates in analyses. Current combustible and e‐cigarette users reported significantly more sleep difficulties than never users. Users of e‐cigarettes reported greater use of sleep medication than combustible cigarette users. Similar to combustible cigarette smoking, e‐cigarette use (vs. non‐use) was associated with worse sleep health, even among non‐daily e‐cigarette users. These findings may indicate a need for assessment of and education on the role of e‐cigarette use in sleep health among individuals who report experimentation with or current use of e‐cigarettes. Future research should examine these relationships prospectively. [ABSTRACT FROM AUTHOR]

The purpose of this study was to investigate the association between unrealistic optimism (UO) and risky sexual behavior (RSB) and related consequences in a college student sample. Participants believed they had significantly lower personal risk of engagement in alcohol-related sexual activity, unintended pregnancy, and STIs than the average college student (ps < 0.01). Compared to national data, participants significantly underestimated likelihood of HPV and sexual engagement with four or more partners in the next year (ps < 0.01). Findings support evidence of UO relating to RSB-related consequences, indicating need for improvements in sexual health education and intervention. [ABSTRACT FROM AUTHOR]

Objective: Research suggests college students rate some alcohol-related consequences less negatively than others, yet it is unclear how or when these differences in perception develop. The current study compared college students' subjective evaluations of alcohol-related consequences that they had and had not experienced in order to test the hypothesis that students become desensitized to the consequences they experience. Participants: Participants were 269 undergraduate students enrolled at a large, public, Midwestern university. Methods: Participants completed measures of drinking behaviors, consequences experienced, and subjective evaluations of consequences via an online survey. Results: Participants rated the consequences they had personally experienced more positively than those they had not experienced. Similarly, individuals who reported experiencing consequences rated them as significantly more positive than those who had not experienced the same consequences. Conclusions: Experience with consequences is associated with more positive evaluations of those consequences. Therefore, it may be important to consider individuals' experiences with, and evaluations of, alcohol-related consequences in college student drinking interventions. [ABSTRACT FROM AUTHOR]

Objective: Personalized feedback interventions (PFIs) have been associated with decreased alcohol consumption and related problems among college students; however, the necessary and sufficient components responsible for efficacy remain unclear. The present study investigated the relative efficacy of 3 computerized PFIs with differing content, the content-specific mechanisms of change within PFIs, and the moderating roles of comparison orientation and baseline risk in intervention outcomes. Method: College students (TV = 212) reporting alcohol use in a typical week completed an assessment prior to randomization (norms PFI, enhanced PFI, choice PFI, assessment only) and 1 month postintervention. Results: Participants who received a PFI reported greater decreases in alcohol use, peak blood alcohol concentration (BAC), related problems, and perceptions of typical students' drinking than those in the control group. Neither tendency to compare oneself with others nor baseline risk moderated outcomes. PFIs influenced weekly alcohol use indirectly through changes in descriptive normative perceptions and alcohol-related consequences indirectly through changes in peak BAC. Conclusions: Computerized PFIs are more effective than assessment alone in decreasing alcohol use and related problems among college students. Normative comparisons may be sufficient to elicit behavior change, and inclusion of select additional components may not yield significant improvements in outcomes. However, the consistent benefit of including feedback on physical and monetary costs of drinking and moderation strategies, although nonsignificant, may warrant the negligible increase in time and money required to provide such information electronically. Computerized PFIs seem to be an ideal first step to the prevention and treatment of college alcohol misuse. [ABSTRACT FROM AUTHOR]

Although personalised feedback interventions (PFIs) for alcohol misuse among college students have demonstrated reliable efficacy, effect sizes are modest and little improvement in efficacy has been observed in the last 15 years. More systematic and explicit application of theory may enhance our understanding of PFI mechanisms and lead to incremental improvements in efficacy. The current review identified intervention trials of PFIs (N = 93), the theoretical frameworks (N = 20) on which they were based, the extent to which theory was utilised in development and evaluation of the intervention, and the principles of behaviour change implicated in each of those theories. Though the majority of studies identified a theoretical framework for interventions, theory is not being tested uniformly across current studies of PFIs. A review of the most commonly cited theories resulted in identification of 11 theoretical principles of behaviour change: alternatives to behaviour, autonomy, commitment, expectancies, goals/change plan, interpersonal discrepancy, intrapersonal discrepancy, awareness of contingent outcomes, self-efficacy, skills necessary to overcome barriers and therapeutic relationship. Potential applications of these theoretical principles in PFI development and testing are discussed. [ABSTRACT FROM PUBLISHER]

Objective: To examine the efficacy of a self-affirmation task in deterring college alcohol misuse and the importance of preexisting beliefs in predicting subsequent behavior change. Participants: Heavy-drinking undergraduates (N = 110) participated during the 2011–2012 academic year. Methods: Participants were randomized to complete an affirmation or control task before reading an alcohol risk message. Alcohol-related beliefs and behaviors were assessed. Participants completed a 2-week online follow-up assessing alcohol-related behaviors. Results: Both groups reported increased perceived problem importance, but neither group displayed changes in personal risk. Follow-up assessment revealed similar, significant declines in peak consumption in both groups, with no significant between-group differences. Preexisting beliefs accounted for 5% to 10% of variance in drinking outcomes. Conclusions: An affirmation task does not seem to decrease defensive processing or alter high-risk drinking behaviors among college students and should not be utilized in lieu of more effective strategies. [ABSTRACT FROM AUTHOR]

Abstract: Research on the efficacy of computer-delivered feedback-only interventions (FOIs) for college alcohol misuse has been mixed. Limitations to these FOIs include participant engagement and variation in the use of a moderation skills component. The current investigation sought to address these limitations using a novel computer-delivered FOI, the Drinkers Assessment and Feedback Tool for College Students (DrAFT-CS). Heavy drinking college students (N =176) were randomly assigned to DrAFT-CS, DrAFT-CS plus moderation skills (DrAFT-CS+), moderation skills only (MSO), or assessment only (AO) group, and were assessed at 1-month follow-up (N =157). Participants in the DrAFT-CS and DrAFT-CS+groups reported significantly lower estimated blood alcohol concentrations (eBACs) on typical heaviest drinking day than participants in the AO group. The data also supported the incorporation of a moderation skills component within FOIs, such that participants in DrAFT-CS+group reported significantly fewer drinks per week and drinks per heaviest drinking occasion than participants in the AO group. [Copyright &y& Elsevier]

The article offers information on a research report related to stimulant medication use in college students. It informs that stimulant medication is prescribed to treat attention-deficit and hyperactivity disorder in children and adolescents. It mentions that comparison of the characteristics of four groups of college students including those with stimulant prescriptions for appropriate users, misusers and nonusers is determined. It discusses about the efficacy of stimulants.

The article describes a study which determined student perceptions of and preferences for different types of alcohol-related feedback components included in personalized feedback interventions (PFIs) in a sample of in undergraduates, who rated their affinity for and skepticism of feedback components and identified the most preferred feedback component. It states that the high-risk drinkers reported lower ratings for all feedback components and men provided lower ratings as compared to women.

Abstract: This study evaluated the efficacy of two brief personalized feedback interventions (PFIs) using identical feedback and motivational interviewing strategies aimed at reducing alcohol consumption and alcohol-related problems to two control conditions among a sample of high-risk drinking college students. Students (N = 152) were randomly assigned to a computer-delivered PFI with a video interviewer, a face-to-face PFI with a live interviewer, a comprehensive assessment condition, or a minimal assessment-only condition. At 10 weeks posttreatment, the face-to-face PFI significantly reduced weekly drinking quantity and peak and typical blood alcohol concentration compared with the comprehensive assessment and minimal assessment-only conditions (d values ranged from 0.32 to 0.61). No significant between-group differences were evidenced for the computer-delivered PFI condition, although effect sizes were comparable to other college drinking studies using computer-delivered interventions (d values ranged from 0.20 to 0.27). Results provide further support for the use of a face-to-face PFI to help reduce college students'' alcohol consumption and suggest that a video interviewer in the context of a computer-delivered PFI is likely a helpful but not necessarily a complete substitute for a live interviewer. [Copyright &y& Elsevier]

Individuals with high self-esteem who engage in risky health behaviours often minimize the associated health risks; individuals with low self-esteem do not demonstrate such minimization. The influence of gender on health risk perceptions is less clear. This study examined the influences of gender and self-esteem upon college students' responses to an alcohol risk message. Three-hundred-and-four alcohol-using college students read an NIAAA sponsored message regarding the risks associated with alcohol use. Results revealed that self-esteem and gender significantly and independently predicted alcohol-related attitudes, intentions, and follow-up behaviour. Females, especially those with low self-esteem, demonstrated greater alcohol-related concerns immediately after reading the message, while males exhibited more self-serving attitudes. In addition, high self-esteem participants and males reported fewer intentions to reduce drinking behaviour. At follow-up, higher self-esteem was associated with greater drinking frequency relative to lower self-esteem. Furthermore, males with higher self-esteem reported the greatest binge frequency compared with all other groups. These findings suggest that individuals with higher self-esteem and males are particularly resistant to information regarding the negative consequences of alcohol use. [ABSTRACT FROM AUTHOR]

Abstract: Previous research has found that individuals who engage in risky health behaviors respond to health risk messages in a self-serving manner, limiting the impact of health messages among targeted individuals. The present study sought to investigate whether alcohol-using college students would respond to risk messages about alcohol use with a similar defensive bias. Both alcohol-using (N =244) and non-using (N =91) college students read a summary of alcohol risk information intended for college students. Participants then reported their attitudes about the seriousness of the problem of college drinking, personal risk, and the scientific credibility of the risk information. Results indicated that high-risk participants responded in a self-serving manner, with significantly lower ratings of problem importance among alcohol-using students and non-significant differences among assessments of personal risk between groups. Further, alcohol-using students were more critical of the scientific merit of the risk information and more skeptical about the empirical claims. Defensively biased responding was more pronounced among more frequent and heavy drinking students than among lighter drinking students. The implications of these findings as well as possible ways to reduce defensive bias are discussed. [Copyright &y& Elsevier]

Alcohol-induced amnesia ("blackout") is a reliable predictor of alcohol-related harm. Given its association with other negative consequences, experience of alcohol-induced amnesia may serve as a teachable moment, after which individuals are more likely to respond to intervention. To test this hypothesis, alcohol-induced amnesia was evaluated as a moderator of brief intervention effect on (a) alcohol-related consequences and (b) the proposed intervention mediators, protective behavioral strategies and peak blood alcohol concentration (BAC). Baseline alcohol risk measured using the Alcohol Use Disorders Identification Test (AUDIT) was also evaluated as a moderator to rule out the possibility that amnesia is simply an indicator of more general alcohol risk. College students (N = 198) reporting alcohol use in a typical week completed assessments at baseline and 1-month follow-up as part of a larger intervention trial. Participants were randomized to assessment only (AO; n = 58) or personalized feedback intervention (PFI; n = 140). Hierarchical regression was used to examine direct and indirect intervention effects. A significant group-by-amnesia interaction revealed that only PFI participants who had experienced alcohol-induced amnesia in the past month reported decreases in alcohol consequences at 1-month follow-up. The PFI reduced alcohol-related consequences indirectly through changes in peak BAC, but only among those who had experienced amnesia at baseline. In contrast, baseline alcohol risk (AUDIT) did not moderate intervention effects, and use of protective behavioral strategies did not statistically mediate intervention effects. Findings suggest that loss of memory for drinking events is a unique determinant of young adult response to brief alcohol intervention. Normative feedback interventions may be particularly effective for individuals who have experienced alcohol-induced amnesia in the past 30 days. [ABSTRACT FROM AUTHOR]

One-third of college students report past-year heavy episodic drinking, making college student alcohol use an important area for continued research. Research has consistently linked early experiences of adversity to problematic substance use in adolescence and adulthood. Given the negative health consequences associated with heavy episodic drinking, it is imperative to identify mechanisms that contribute to this relation. Low levels of mindfulness have been linked to early adversity as well as impulsivity and alcohol use, therefore, the current study aims to examine the mediating role of mindfulness in the relation between early adversity and current alcohol use and consequences. Undergraduate students (N = 385) at a Midwestern university completed an online questionnaire assessing experiences of childhood adversity, trait mindfulness, and current alcohol use and related consequences. Results indicated that increased adverse experiences and lower levels of mindfulness predicted both increased alcohol consumption and consequences (ps < 0.025), with mindfulness mediating the relationships. Mindfulness is a predictor of alcohol outcomes and appears to mediate the relation between early adversity and alcohol use and consequences. Findings suggest that students with a history of adversity are more likely to exhibit lower levels of mindfulness, which may lead to an increase in alcohol consumption and consequences in early adulthood. Targeted alcohol intervention efforts that incorporate mindfulness skills may be particularly beneficial for those who have experienced early adversity. [ABSTRACT FROM AUTHOR]

Introduction: Smoking tobacco via a waterpipe (WP) is on the rise, particularly among college students. One reason for this may be normative perceptions of WP tobacco smoking (WTS) among this population. The current study examined the perceived and actual descriptive and injunctive norms of WTS among a college student sample.Methods: Participants were 894 college students enrolled at a large, Midwestern university. Participants completed measures of WTS frequency and quantity and perceived/actual descriptive and injunctive norms of WTS.Results: Over one-third of the sample reported ever trying WTS, while only 2% reported current (past month) use. When comparing ever and never WP smokers, ever smokers reported greater perceived peer approval of WTS. Both males and females overestimated WTS frequency of same-sex students at their university.Discussion: The current study is one of the first to investigate descriptive and injunctive norms of WTS among college students. Students who report WTS are more likely to overestimate descriptive norms of WTS among their peers, suggesting corrective normative feedback regarding actual use by peers may be an important target for WTS intervention among college students. Future research should investigate the temporal association between normative perceptions and WTS behaviors among college students. [ABSTRACT FROM AUTHOR]

Developing discrepancy between one's values and behaviors is theoretically important in motivating change; however, existing studies lack a validated measure of value-behavior discrepancy for alcohol misuse. The current studies aimed to modify Wilson & DuFrene (2008) Valued Living Questionnaire (VLQ) to assess consistency of alcohol use with important values. In Study 1, the initial factor structure and test-retest reliability of the VLQ for Alcohol Use (VLQ-A) was tested in a sample of college students who regularly drink alcohol (N = 150). Results guided modifications to the measure. In Study 2, the revised measure's factor structure and predictive validity were tested with a second sample of college students who drink alcohol (N = 222). In both studies, exploratory factor analysis supported a unidimensional factor structure. Perceived discrepancy between alcohol use and important values predicted greater readiness to change, while perceived consistency between alcohol use and important values predicted more frequent heavy episodic drinking. Certain values were more useful in predicting outcomes than others. Alcohol use (heavy vs. moderate drinking) did not moderate outcomes. The VLQ-A is a brief and reliable self-report measure of perceived discrepancy between drinking behaviors and important values that may increase readiness to change. Future research examining the generalizability of findings to various samples and the efficacy of the VLQ-A as a supplement to brief interventions is warranted. (PsycINFO Database Record [ABSTRACT FROM AUTHOR]

Background: Personalized normative alcohol feedback (PNF) is associated with decreased alcohol use among young adults. However, limited research has examined the influence of depressive symptoms on PNF efficacy. This study examined symptoms of depression as a moderator of college student response to a computerized PNF intervention for alcohol use.Methods: College students (N = 212, 59% female) who reported drinking in a typical week completed baseline and one-month assessments as part of a previously published intervention trial. We randomized participants to alcohol PNF (n = 153) or assessment only (n = 59). We used regression models to examine the interaction between PNF and symptoms of depression on alcohol outcomes at one-month follow-up.Results: One in four participants screened positive for clinically significant symptoms of depression. Depressive symptoms did not moderate intervention effects on drinking quantity. However, PNF was only associated with reduced frequency of heavy episodic drinking and lower probability of any alcohol-related consequence in the context of mild to moderate (not minimal) symptoms of depression.Conclusions: PNF is more effective than assessment alone in reducing drinking quantity, regardless of symptoms of depression. However, it may only be more effective in decreasing frequency of heavy episodic drinking and the probability of alcohol-related consequences among those experiencing mild to moderate (as opposed to minimal) symptoms of depression. Alcohol intervention trials should assess symptoms of depression and consider them in data analysis. [ABSTRACT FROM AUTHOR]

Introduction: Personalized feedback interventions (PFIs) are associated with small but reliable decreases in alcohol consumption among college students. While they often include information regarding protective behavioral strategies (PBS), PFIs do not typically include feedback aimed to modify normative perceptions of PBS. This study aimed to enhance the efficacy of existing PFIs among college students by incorporating normative feedback on participants' use of PBS.Methods: Students enrolled in undergraduate courses (N = 268) completed baseline and 1-month follow-up assessments of past-month use of PBS, normative perceptions of PBS use, alcohol consumption, and alcohol-related consequences. Participants were randomized to one of three conditions: typical feedback on PBS (typical strategies PFI), descriptive normative feedback on PBS (strategy norms PFI), or assessment-only control (AOC). Participants in the typical strategies PFI and strategy norms PFI conditions received web-based personalized feedback profiles.Results: Compared to AOC, both the strategy norms PFI and typical strategies PFI were effective in correcting participants' perceptions of other students' engagement in PBS (p = .01) but did not differ significantly from one another. No statistically significant differences were observed between conditions in terms of actual PBS use, alcohol consumption, or alcohol-related consequences at 1-month follow-up (p > .05).Discussion: The strategy norms and typical strategies PFIs were both successful in increasing normative perceptions of PBS use, indicating that general (rather than normative) feedback regarding PBS use may be sufficient for changing perceptions of PBS use. [ABSTRACT FROM AUTHOR]

Background: JUUL electronic cigarettes have surged in popularity since their emergence on the market in 2015. JUUL is slim and simple in design and is capable of delivering cigarette-like levels of nicotine. However, little research has examined JUUL use patterns, reasons for use, and normative perceptions of JUUL among young adults.Methods: Participants were college students (N = 243) who reported ever using a JUUL electronic cigarette. Eligible participants completed a survey assessing JUUL use patterns, reasons for JUUL use, and normative perceptions of JUUL.Results: Most participants reported using JUUL once or twice (47.7%) and almost one-third reported using JUUL daily or monthly (29.6%). Overall, participants reported a low level of nicotine dependence (Melectronic cigarette HONC = 0.93, SD = 2.04). Cool Mint was the most preferred flavor (35.8%) followed by Mango (12.0%). The top reasons for use were because "friends were using it" (27.0%) and "curiosity" (19.4%). Nearly half (49.8%) of participants reported that they would tell all five of their five closest friends that they use JUUL. Only 10.7% reported a belief that none of their friends would approve of their JUUL use.Conclusions: The high percentage of daily and monthly JUUL users coupled with the relatively high rates of perceived acceptability of use indicates the possibility of high uptake among college students. Findings also suggest college students perceive JUUL as highly acceptable and that their friend's use and curiosity were primary motivators of their initial use, indicating the importance of peer influence in college student JUUL use. [ABSTRACT FROM AUTHOR]