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Description
Background: Young adults are navigating contradictory claims about e-cigarettes as alternatives for regular cigarettes. While marketing messages promote e-cigarettes as superior alternatives, public agencies issue cautionary health warnings about possible harms of e-cigarette use. As a result, youth may experience attitudinal ambivalence, which is an equal amount of positive and negative attitudes, toward e-cigarette use. While research has indicated that exposure and receptivity to e-cigarette marketing influences product use, no work has examined the extent to which this ambivalence about the harms and benefits of e-cigarettes leaves consumers vulnerable to the effects of e-cigarette marketing. This study addresses this gap and seeks to understand the interrelationships between: (a) e-cigarette use perceptions (b) attitudinal ambivalence regarding e-cigarette use, and (c) exposure and receptivity to e-cigarette messages. Methods: A sample of 350 undergraduate students participated in an online experimental design, in which they were randomly assigned to pretest-posttest condition or posttest only condition. Participants were randomly exposed to one of the e-cigarette message conditions: (1) message argument supporting possible benefits of e-cigarette smoking, (2) message argument harms of e-cigarette smoking, (3) ambiguous message with one argument each for benefit and one harm of e-cigarette smoking. Results: Message condition has no significant effect on e-cigarette use perceptions. Message receptivity has a strong influence on e-cigarette benefit perceptions of e-cigarette use posttest attitudinal ambivalence. Pretest attitudinal ambivalence has persisting carryover effects on posttest attitudinal ambivalence. Asian population reported the least harm perceptions of e-cigarette use in comparison to other ethnic groups. Discussion: The vulnerability of young people lies in them harboring highly pliable benefit perceptions of e-cigarettes that are influenced more by message receptivity than message condition. Attitudinal ambivalence about e-cigarette use emerges as an attitude that is resilient to any message condition. Practitioners should investigate simulated or real word of mouth campaigns using narrative messaging or social media initiatives, to help youth transition to a stage of informed univalence. Future theoretic work should explore ambivalence as a multi-dimensional attitude that prolongs vulnerability to risk behavior
