Date of Award


Document Type

Doctoral Research Project

Degree Name

Doctor of Psychology (PsyD)



First Advisor

Vida L. Tyc

Second Advisor

Richard T. Elmore Jr.

Third Advisor

Theodore G. Petersen

Fourth Advisor

Robert A. Taylor


First Responders to emergencies, such as those within the fields of law enforcement, firefighting, and/or emergency medical services, have a higher use of Electronic Nicotine Delivery System (ENDS)than the population in general due to the intense job-related stressors they often encounter as part of their work and the well documented relationship between stress and use of these products. The purpose of this study was to determine the rate of First Responders who utilize ENDS and engage in stealth vaping, and the association between these behaviors and self-perceived level of job stress, health risk perceptions, and other factors. A total of 757 participants were included in the study (Mage = 33.59, SD =10.90, age range: 18-74), including 359 (47.5%) men, 395 (52.2%) women. Results from our current study found that 31% of First Responders currently vaped, 22.2% were current smokers, and 11% were current dual users. Of those respondents who endorsed vaping behaviors, 38.0% endorsed stealth vaping, or non-adherence to the workplace rules some of the time and 31.0% endorsed stealth vaping within their work vehicles. While these results were significantly lower than that of the general population (χ2(1, N =357) = 6.91, p < .05 and χ2(1, N =360) = 30.39, p < .001, respectively), they highlight a need for intervention to further reduce stealth vaping behaviors in workplace settings.

A significant association between stress levels and vaping and dual use status among First Responders was found; those who reported greater overall stress levels were more likely to be vapers (χ2(1) =49.17, p < .001) and dual users ( χ2(1) = 29.98, p < .001). Significant differences in health risk perceptions, F(3, 756) = 59.57, p < .001, were also found, depending on smoking and vaping status. First Responders who reported less risk with ENDS use and viewed ENDS as a safer alternative to smoking were more likely to vape. Almost 70% (69.5%) of First Responders perceiving vaping as an effective method of smoking cessation. Lastly, psychosocial factors were examined, with results indicating First Responders who endorsed current ENDS use were significantly more likely to report residing with individuals who smoked, χ2(1) = 4.47, p < .05 and vaped, χ2(1) = 161.47, p < .001, as well as having more friends who vaped, χ2(1) = 60.14, p < .001 compared to non-vapers. This study addressed many of the gaps that are seen within the ENDS literature, specifically with regards to stealth vaping within the First Responder population. Results from this study indicate the importance of psychoeducation regarding the risks associated with vaping, vaping as a smoking cessation tool, and the importance of regulations for vaping in the workplaces of First Responders. Additionally, targeted interventions that include stress management, peer-support groups, and identifying alternative coping methods are warranted.


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