Date of Award


Document Type

Doctoral Research Project

Degree Name

Doctor of Psychology (PsyD)



First Advisor

Vida L. Tyc

Second Advisor

Patrick J. Aragon

Third Advisor

Catherine Nicholson

Fourth Advisor

Lisa Steelman


While there has been an extensive amount of research on tobacco use in children and adolescents, very little has been conducted in children with developmental delays, particularly Autism Spectrum Disorders (ASD). Similarly, research examining newer methods of nicotine use, such as electronic nicotine delivery systems (ENDS; ecigarettes) has not yet been conducted in this population. It has previously been assumed that characteristics commonly observed in youngsters with ASDs serve as protective factors for the initiation of tobacco and ENDS use; however, no studies have identified the variables that contribute to a youngster’s intention to smoke/use ENDS in this vulnerable population. Previous studies have examined the contributing role of exposure to secondhand smoke in the child’s home and vehicle, particularly from parents, to tobacco use among youth but the impact of exposure from parents who use e-cigarettes has not been explored. This study aimed to determine rates of combustible cigarettes and ENDS use, smoking and vaping rates in family homes and vehicles, and identify the factors associated with future intentions to use tobacco/ENDS among youngsters with ASD.

A total of 70 children (ages 10-17 yrs) and their parents/guardians were enrolled on this study and completed an online questionnaire about their smoking and vaping habits. Of the parents who chose to provide their child’s demographic information, the mean age of children in the sample was 12.68 years (SD = 2.29; range = 10 to 17 years) and the gender distribution was 78.6% male (n = 55) and 20.0% female (n = 14). Half of children (50%) endorsed a history of cigarette use, 45.7% endorsed a history of ENDS use (n = 32), and 86.5% of children used tobacco also used ENDS products (n = 32). Older children were more likely to smoke , (t (63)= -2.36, p = .021), and child smoking status was significantly associated with having a parent who smoked, X2 (1, N = 70) = 16.95, p = 0.00, having peers who smoked, X2 (1, N = 70) = 42.13, p = 0.00, and exposure to cigarettes in the home, X2 (1, N = 70) = 13.83, p = 0.00, and car, X2(1, N = 70) = 8.00, p = 0.01. Children who vaped were older (t (63) = -2.99, p = .004), and child vaping status was significantly associated with parent vaping status, X2 (1, N = 70) = 9.11, p = 0.00, peer vaping status, X2 (1, N = 70) = 4.14, p = 0.05, and exposure to ENDS in the home, X2 (1, N = 70) = 17.98, p = 0.00, and vehicle, X2 (1, N = 70) = 8.23, p = 0.01. There were no significant differences in intentions to smoke and vape in the future among current non-smokers and nonvapers based on demographic and tobacco/ENDS-related variables. Less than half of parents reported complete smoking (46%) and vaping bans (37%) in the home, which is lower than rates reported in prior studies. Similarly, 34% endorsed vaping bans in the vehicle. The collective findings from this study will inform targeted interventions to prevent later tobacco/ENDS use among these at-risk youngsters


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