Above the influence of vaping: Peer leader influence and diffusion of a network-informed preventive intervention

Peter A. Wyman, Kelly Rulison, Anthony R. Pisani, Eusebio M. Alvaro, William D. Crano, Karen Schmeelk-Cone, Chelsea Keller Elliot, Joshua Wortzel, Trevor A. Pickering, Dorothy L. Espelage

Research output: Contribution to journalArticlepeer-review

10 Scopus citations


Using social networks to inform prevention efforts is promising but has not been applied to vaping. To address this gap, we pilot tested the peer-led Above the Influence of Vaping (ATI-V) and examined diffusion through 8th grade networks in three schools. Fifty students, nominated and trained as Peer Leaders, implemented prevention campaigns informed by communication science, including gain-loss messaging and social norming. Across schools, 86–91% of students (N = 377) completed measures (pre-post) of electronic vaping product (EVP) use and attitudes, and named close friends and adults to construct social networks. Using baseline reports, we classified students as Recent EVP Users (10%), Vulnerable Nonusers (24%), or Resolute Nonusers (66%). Peer Leaders had reach through friendship connections to students at varying risk of vaping; 12–16 weeks after Peer Leaders were trained and began implementing campaigns, 79% of Resolute Nonusers and 74% of Recent Users/Vulnerable Nonusers reported exposure to a vaping prevention message. Students with more Peer Leader friends were less likely to report recent EVP use (OR = 0.41) or intention to use an EVP (B = 0.12) on post-surveys, supporting the intervention conceptual model positing diffusion through friendship networks. Use of student-nominated peer leaders was supported by network analyses showing EVP Users integrated within the friendship network, having more high-risk friends, and fewer adult connections. This evidence is the first to show that adolescent Peer Leaders with ongoing mentoring and science-informed campaigns can potentially reduce EVP acceptability and use. Areas for refining ATI-V include increasing consistency of campaign exposure across schools.

Original languageEnglish (US)
Article number106693
JournalAddictive Behaviors
StatePublished - Feb 2021

All Science Journal Classification (ASJC) codes

  • Medicine (miscellaneous)
  • Clinical Psychology
  • Toxicology
  • Psychiatry and Mental health


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