Our theoretical foundation is built upon the PRIME behavioural theory by Robert West describing plans, responses, impulses, motives, and evaluations as related to addictive behaviour [34]. Diverging from other behavioural theories i.e., theory of planned behaviour, theory of reasoned action, amongst others, that focuses on the nature of intention [31], PRIME focuses on the nature of impulsivity and inhibition [26]. The PRIME perspective explains that impulsivity is the drive behind an individual’s susceptibility to an addictive behaviour while inhibition is the drive behind an individual’s ability to refrain from an addictive behaviour [35]. Regarding impulsivity, an individual’s prior intent (or plan) to act on an addictive behaviour, encouragement from outer environmental or personal motivators to act on the addictive behaviour, as well as positive evaluations (or beliefs) about such addictive behaviour can stimulate an irresistible response to act on such behaviour [36]. However, in the presence of inhibition, an individual’s prior intent not to act on an addictive behaviour, discouragement from outer environmental or personal motivators on the addictive behaviour, as well as negative evaluations about such addictive behaviour can generate an ability to resist the desirable urge to act on such behaviour [37]. Thus, impulsivity is laced by irrationality while inhibition is laced by rationality [38].
A variety of existing studies have successfully shown the applicability of inhibition based on PRIME’s perspective to effective tobacco smoking cessation efforts [33, 39–41]. Nevertheless, PRIME’s relevance to the understanding of impulsivity as related to tobacco smoking is less well studied [31]. Considering that PRIME is a developing theory [42], empirical studies from not just the angle of inhibition, but also the angle of impulsivity are both of relevance in expounding its applicability to the understanding of an addictive behaviour like tobacco smoking. The present study formulates a predictive model which indicates that there is a positive link between impulsivity, intent (or plan), and positive evaluations (or beliefs) as suggested in existing studies on youths’ WTS [7, 43]. Also, based on prior evidences [23, 44], we include social media normalisation of WT as an outer environmental factor that can moderate the relationship between intention, positive evaluations, and impulsivity among the youths.
Hypotheses development
We developed hypotheses for the concepts of intention to smoke waterpipe tobacco, positive evaluations of waterpipe tobacco, and social media normalisation of waterpipe tobacco.
Intention to smoke waterpipe tobacco (ITSW). Intention refers to the willingness to carry out an action [45]. In the context of this study, intention refers to the willingness to smoke WT which can generate an impulsiveness or urge to smoke it. Studies have shown that the readiness to experiment with WT constitute the urge to smoke it among majority of the youths [9, 10, 20, 43, 46]. In Nigeria, willingness is also a key factor in the growing tendency to smoke WT among the youths, particularly those in the university [11]. As such, we assume that there is a positive connection between intention and impulsivity among the Nigerian youths who tend to smoke WT. Thus, we propose the following hypothesis:
H1. Intention to smoke waterpipe tobacco will be positively related to impulsivity among the Nigerian youths who have a tendency to smoke waterpipe tobacco.
Positive evaluations of waterpipe tobacco (PEOW). Positive evaluations entail the beliefs, feelings, or notions that depicts something in an advantageous manner [47]. In the context of waterpipe tobacco, positive notions that WT is merely trifling in terms of harm and addiction persists among many of the youths thereby instigating their continuous urge to smoke it [7]. Further stimulating the youths’ tendency to smoke WT are such positive feelings as it being sociable, tasty due to flavours, entertaining, amongst others [48]. Positive feelings about WT also relates to the Nigerian context as many of the youths are known to mostly consider it as more of a fun activity [29]. Consequently, we propose that there is a positive association between positive evaluations and impulsivity among the Nigerian youths who tend to smoke WT and hypothesised that:
H2. Positive evaluations of waterpipe tobacco will be positively related to impulsivity among the Nigerian youths who have a tendency to smoke waterpipe tobacco.
Social media normalisation of waterpipe tobacco as a moderator (SMNW). Social media normalisation of waterpipe tobacco indicates the enormous depiction of WT on social media platforms like Facebook, Twitter, Instagram, YouTube, etc, as mostly a normal and acceptable behaviour rather than a highly detrimental one [49]. The illustration of WT on social media is quite bothersome as while harmful potential is often acknowledged in the social media messages related to other tobacco smoking methods like cigarette for instance [44], those associated with WT regularly describe it as more of a safer tobacco smoking alternative [23]. In fact, majority of the texts, pictures, videos, and other graphics related to WT on social media are reportedly representative of waterpipe as socially acceptable, fun, interesting, entertaining, enjoyable, attractive, amongst others [50, 51]. Studies have shown that exposure to pro-smoking social media messages increases the youths’ tendency to smoke tobacco [52, 53], especially among those who hold positive beliefs and are willing to experiment with tobacco [54]. Taken together, we therefore consider that the positive relationship between intention, positive evaluations, and impulsivity will be more intense among the youths with high exposure to pro-smoking social media messages that relate to WT. Consequently, we hypothesised that:
H3a. Social media normalisation of waterpipe tobacco will moderate the positive relationship between intention and impulsivity such that the tendency to smoke waterpipe tobacco will be stronger for the Nigerian youths with high exposure to pro-smoking social media messages relating to waterpipe tobacco.
H3b. Social media normalisation of waterpipe tobacco will moderate the positive relationship between positive evaluations and impulsivity such that the tendency to smoke waterpipe tobacco will be stronger for the Nigerian youths with high exposure to pro-smoking social media messages relating to waterpipe tobacco.
(Please insert Fig. 1 here)