Gendered Motivations for E-Cigarette Use Among Native Hawaiian and Pacific Islander Youth: A Relational-Cultural Perspective

E-cigarette use among youth has become a significant public health issue, with Native Hawaiian and Pacific Islander (NHPI) youth exhibiting some of the highest usage rates in the United States. Despite the role of gender-specific motivations in shaping substance use behaviors, limited research has examined these dynamics within NHPI populations. This study explored the gendered influences on e-cigarette use and non-use among rural NHPI youth through data collected from 17 gender-specific focus groups (N = 69) conducted across eight public schools on Hawai'i Island. Key findings revealed two distinct themes: girls emphasized relational harmony, basing their decisions on the impact to familial and peer relationships, whereas boys were primarily driven by individual goals, such as enhancing athletic performance and avoiding negative consequences. These insights underscore the necessity for culturally tailored, gender-specific prevention strategies that address the unique relational and individual factors affecting NHPI youth substance use behaviors.