Network Dynamics of Social Influence on E-cigarette Use Among an Ethnically Diverse Adolescent Cohort

These findings demonstrate the role of social influence on adolescent e-cigarette use through two mechanisms, both friend behavior and social norms. A shift in prevention strategies toward addressing social dynamics and social norms rather than focusing solely on individual-level factors may be effective in curtailing use. Changing social perceptions and reducing the social acceptability of e-cigarette use may help slow the spread in adolescent networks.