Teen Vaping Risks: It's Time to Clear the Air

CON T EMPORARYP ED I AT R I C S . C O M | A U G U S
T 2 01724
PEER-REVIEWED FEATURE
Teen
Vaping
Dr Douglass is DNP program
director and assistant
clinical professor, DNP
Program and Nurse
Practitioner Programs,
Drexel University College
of Nursing and Health
Professions, Division of
Nursing, Graduate Nursing
Programs, Philadelphia,
Pennsylvania.
Dr Solecki is assistant
clinical professor of nursing,

DNP Program and Nurse
Practitioner Programs, Drexel
University College of Nursing
and Health Professions,
Division of Nursing,
Graduate Nursing Programs,
Philadelphia. The authors
have nothing to disclose in
regard to affiliations with
or financial interests in any
organizations that may have
an interest in any part of this
article.
The vaping culture of using non–cigarette
tobacco and electronic nicotine delivery
systems (ENDS) is the latest risky trend
among adolescents and young adults. Vap-
ing is the use of high-tech, advanced elec-

tronic devices such as electronic cigarettes
(e-cigarettes), refillable atomizers, and
other tobacco products as an alternative
or in addition to regular cigarettes.1 A con-
cerning 10-fold to 11-fold rapid rise noted
in middle and high school students poses
dangers of nicotine exposure to the pediat-
ric population.2
This article will explore the risk-taking
behavior of adolescents engaging in vaping;
the effects of vaping and the indiscriminate
use of nicotine products on the young; and
strategies that healthcare providers can use
to collaborate with patients and families to
reduce their risk of harm from this emerging
public health epidemic.
Background
The first e-cigarette was conceptualized

and patented in 1965 by Herbert Gilbert as
a safe and harmless modality to smoking
cigarettes.3,4 In 2003, an electronic atomiz-
er version was patented by Ruyan Technol-
ogy in China, marketed to the United States
in 2007, and touted as a healthier alternative
to smoking conventional cigarettes.3 Since
the emergence of Ruyan’s first-generation
e-cigarette, novel models have emerged in
design, engineering, and nicotine delivery
methods resulting in second-, third-, and
fourth-generation ENDS delivery devices.4
Modern generation devices have included
mid-sized e-cigarettes known as personal va-
porizers (PVs), which are similar to a pen or
laser pointer.4 The advanced personal vapor-
izers (APVs) contain a mechanical firing de-
vice called a “mod” (short for “modification”)

that may be used in conjunction with differ-
ent atomizers (tank systems), and they vary in
size, shape, and delivery methods. The most
innovative and advanced devices, however,
are regulated “vape mods,” which contain
an internal circuitry. Lingo used among the
diversity of delivery devices includes vapes,
vape pens, e-cigs, e-hookahs, mods, and tank
systems.3,4
Regardless of the novel delivery devices,
use of nicotine-containing products in any
Teen vaping
Time to clear the air
BRENDA L DOUGLASS, DNP, APRN,
FNP-C, CDE, CTTS; SUSAN SOLECKI,
DRPH, FNP-BC, PPCNP-BC
Vaping has escalated at alarming rates among adolescents
and young adults. It’s time to educate teens about the hidden
health risks of these innocuous nicotine delivery systems.

CONTINUED ON PAGE 28
http://contemporarypediatrics.modernmedicine.com/
T 2 01728
peer-reviewed
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form presents dangers and is unsafe.4
Escalation of misuse
Vaping is a significant public health
concern and has escalated at alarm-
ing rates among adolescents and
young adults. During 2011-2012, data
from the National Youth Tobacco
Survey revealed a modest increase in
e-cigarette use (used 1 or more times
within the past 30 days) among stu-
dents in grades 6 to 12, from 1.1% to

2.1%.4 From 2011 to 2014, the use of
e-cigarettes grew rapidly to 13.4%
of high school students and 3.9%
of middle school students. By 2014,
e-cigarettes had become the most fre-
quently used tobacco product among
young persons, exceeding conven-
tional cigarette use. In 2015, over
3 million middle school and high
school students reported e-cigarette
use, equating to 1 in every 6 school
students, and over 25% reported try-
ing e-cigarettes.
In young adults aged 18 to 24 years,
e-cigarette use (used 1 or more times
within the past 30 days) more than
doubled from 2013 to 2014 to 13.6%,
and as of 2014, more than one-third

had tried e-cigarettes.4 E-cigarette
use data among teenagers and young
adults represent the various product
types of ENDS.3,4
What the vaping
culture entails
Vaping refers to the vaporization of
substances (nicotine, flavorings, can-
nabis, or other substances in popu-
larity) wherein oil, liquid, or plant
material is heated to a temperature
resulting in the release of aerosol-
ized water vapor and active ingredi-
ents (nicotine, cannabis) delivered
via inhaled aerosol.3-5 Tremendous
controversy has arisen surrounding
potential harm reduction or risks as-
sociated with e-cigarettes/vaping in
young persons.3

Nicotine, a highly addictive sub-
stance in any form, is commonly
vaped.3,4 Health effects of nicotine in-
clude hemodynamic effects second-
ary to catecholamines (eg, increase
in heart rate and blood pressure; va-
soconstriction of arteries and vessels;
endothelial dysfunction; atheroscle-
rosis acceleration).3 During adoles-
cence while the brain is developing,
nicotine can result in addiction and
harmful consequences such as be-
havioral and cognitive impairments,
memory issues, inattention, and ex-
ecutive function impairments.4,6
Harmful effects have been found
from e-cigarette aerosol and addi-
tives.4 Brief exposure to propylene

glycol aerosol has been reported to
PEDIATRIC-FOCUSED LINKS ON E-CIGARETTES AND
VAPING
AMERICAN ACADEMY OF PEDIATRICS:
E-Cigarettes and Electronic Nicotine
Delivery Systems bit.ly/AAP-ENDS
CALIFORNIA STATE UNIVERSITY FULLERTON:
Electronic Cigarettes: Information for
Parents bit.ly/CSUF-ecig-parent-info
CAMPAIGN FOR TOBACCO-FREE KIDS:
Electronic Cigarettes: An Overview of
Key Issues bit.ly/tobaccofreekids-
ecig-overview
CENTERS FOR DISEASE CONTROL AND
PREVENTION:
E-Cigarettes and Young People: A Public
Health Concern bit.ly/CDC-ecigs
MYHEALTH.ORG:
The Truth: Is Your Teen Vaping?
bit.ly/myhealthoc-teen-vaping
NATIONAL INSTITUTE ON DRUG ABUSE:

Teens and E-Cigarettes
bit.ly/NIDA-teens-and-ecigs
TV Spotlight on Electronic Cigarettes:
YouTube bit.ly/NIDA-youtube-ecigs
NEMOURS FOUNDATION, DUPONT PEDIATRICS:
KidsHealth: About E-Cigarettes
bit.ly/KidsHealth-ecigs
TeensHealth: E-Cigarettes
bit.ly/TeensHealth-ecigs
US DEPARTMENT OF HEALTH AND HUMAN
SERVICES:
E-Cigarette Use Among Youth
and Young Adults: A Report of the
Surgeon General bit.ly/HHS-ecigs-
SurgeonGeneral-report
Know the Risks: E-Cigarettes and Young
People bit.ly/HHS-ecigs-know-the-
risks
Know the Risks: E-Cigarettes and Young
People. Talk with your Teens About
E-Cigarettes: A Tip Sheet for Parents
bit.ly/HHS-ecigs-parent-tip-sheet
US FOOD AND DRUG ADMINISTRATION:
Vaporizers, E-Cigarettes, and Other
Electronic Nicotine Delivery Systems

bit.ly/FDA-tobacco-products
FROM 2013 TO 2014
E-cigarette use among middle and high school
students tripled, rising from approximately
660,000 to 2 million students19
CONTINUED FROM PAGE 24
http://bit.ly/AAP-ENDS
http://bit.ly/CSUF-ecig-parent-info
http://bit.ly/tobaccofreekidsecig-overview
http://bit.ly/CDC-ecigs
http://bit.ly/myhealthoc-teen-vaping
http://bit.ly/NIDA-teens-and-ecigs
http://bit.ly/NIDA-youtube-ecigs
http://bit.ly/KidsHealth-ecigs
http://bit.ly/TeensHealth-ecigs
http://bit.ly/HHS-ecigs-SurgeonGeneral-report
http://bit.ly/HHS-ecigs-know-therisks
http://bit.ly/HHS-ecigs-parent-tip-sheet
http://bit.ly/FDA-tobacco-products
http://MYHEALTH.ORG
29A U G U S T 2 017 | CON T EMPORARYP ED I AT R I C
S . C O M
peer-reviewed
be a respiratory and eye irritant in
patients without asthma.6 Contem-

porary generations of high-powered
e-cigarettes comprising tank sys-
tems have the capacity to heat nico-
tine liquids to high temperatures that
produce cancer-causing carcinogens
such as formaldehyde and acetalde-
hyde in the vapor.4,6 Metals detected
in some e-cigarette aerosol, includ-
ing lead, silver, tin, nickel, iron, cop-
per, and cadmium, may be products
of the heating element (coil).4
Secondhand e-cigarette aerosol
exposure to nicotine, particles, and
potentially toxic chemicals have been
found in emissions studies.3 The ef-
fects of potentially harmful doses of
heated and aerosolized ingredients of
e-cigarette liquids including solvents,

flavorings, and toxicants are not fully
understood.4
Dual use of vaping nicotine and
smoking cigarettes presents added
health concerns.3,4 An association has
been identified in young persons be-
tween e-cigarette use and the propen-
sity to use other tobacco products, in
particular the use of combustible prod-
ucts (ie, cigarettes).4 To illustrate, 58.8%
of high school students in 2015 report-
ed using e-cigarettes and additionally
combustible tobacco products.
The evolving landscape of rec-
reational and medicinal marijuana
(cannabis) use has given rise to an in-
crease in vaping cannabis.5,7 In 2017,
a study conducted among 3847 high

school students in Connecticut was
consistent with high rates of using
e-cigarettes to vape cannabis (life-
time cannabis user, 18%; lifetime dual
users, 26.5%).7 Besides the potential
for nicotine addiction, addiction risk
exists for cannabis and other illicit
drug use.4 Little is known about the
long-term health effects of vaping and
even less has been established about
the potential harm of vaping other
substances such as cannabis.5
Targeted advertising
Robust marketing and colorful adver-
tising campaigns directed toward the
youth population through social me-
dia outlets, television, and on the In-
ternet proliferated between 2011 and
2013.3,6 One study found television ad-

vertisements soared 256%, reaching
over 24 million young persons.3 Ap-
pealing, child-friendly flavorings are
a marketing endeavor to attract ado-
lescents, disguise harsh tobacco, and
facilitate nicotine addiction.4,6
In 2014, 466 brands and 7764 dis-
tinctive flavors of e-cigarette products
were available.3,4 Emerging evidence
suggests that flavorings when vapor-
ized at high temperatures result in
chemical reactions of toxic levels of
carbonyl compounds such as form-
aldehyde, although the health effects
are not completely appreciated.4,8
Flavorings/taste were among the
3 most commonly reported reasons for
e-cigarette use among teenagers and

young adults along with perceived low
harm as compared with conventional
tobacco products and curiosity.3
Emerging evidence of use patterns
has revealed that e-cigarettes are
being utilized by young persons for
various alterative behaviors such as
smoke tricks, vape competitions, and
vaping other substances including
cannabis and cocaine.8
“Dripping” is one of the newest
trends wherein e-liquid at high tem-
peratures is manually applied direct-
ly on the atomizer coil and the vapor
produced is inhaled.8 In the first study
to evaluate prevalence rates for drip-
ping conducted by Yale University on
high school students (n=7045) from

8 different Connecticut schools,
anonymous surveys evaluated to-
bacco use behaviors and perceptions.
Results of the anonymous surveys re-
vealed that 26.1% of e-cigarette ever
users (n=1080) reported using the
device for dripping, equating to 1 in
4 adolescents. Reasons for dripping
included: thicker vapor clouds (63%);
better-tasting flavors (38.7%); and a
stronger hit produced in the throat
(27.7%) by dripping. Safety studies are
not available on the practice of drip-
ping, although some research sug-
gests e-liquid exposure may have a
considerable increase in toxic vapors
(eg, acetaldehyde, formaldehyde, ac-
etone) and may increase exposure to

high levels of nicotine.
Promoting public
awareness
Adolescents encompass over 20% of
the population in the United States.9
Harm reduction prevention and ear-
ly interventions of risky behavioral
patterns established during the de-
velopmental periods of youth are
not only significant for influencing
adolescents’ current health status,
but also their future health status
In 2014, the products most commonly used
by high school students were:19
e-cigarettes 13.4% || hookah 9.4% || cigarettes 9.2%
cigars 8.2% || smokeless tobacco 5.5% || snus 1.9% || pipes
1.5%
T 2 01730

peer-reviewed
into adulthood. In 1 study in which
teenagers were asked why they used
e-cigarettes, more than half the stu-
dents stated the main reason was
simple curiosity.10 Of concern was
that when asked what they were in-
haling when vaping, more than
60% reported that they were vapor-
izing “just flavoring,” not realizing
e-cigarettes contain nicotine. Only
10% of the adolescent research par-
ticipants stated they were using
e-cigarettes in an attempt to quit
smoking regular cigarettes.
Another alarming problem is the
increase (161% to 333%) in calls to
poison control centers that involve

children aged younger than 5 years
suffering potentially fatal poisonings
through the ingestion, inhalation,
or absorption through the skin or
eyes attributed to access to the liquid
nicotine cartridges, which are not re-
quired to be childproof.3 Concentra-
tions of e-liquid nicotine for refilling
e-cigarettes are ample enough to re-
sult in a fatal overdose sometimes as
high as 1000 mg/10 mL and are com-
monly sold in colorful bottles or car-
tridges attractive to children.3,4
The use of ENDS has achieved no-
toriety to the adolescent population
in particular via the Internet through
social networking and by the promo-
tion of tobacco products using viral

strategies from tobacco companies
that have been directly and indi-
rectly marketing via social media.11
The traditional dissemination of re-
search findings, health information,
and regulatory actions using journal
publications and government reports
to stakeholders involved in this public
health problem may need to be recon-
sidered.12 Technologic advancements
with communication and advertis-
ing outlets may have implications
for public health advocates who will
need to explore alternative strategies
to engage and inform the community
at large on emerging health concerns,
promotion, and prevention.
Parental support and

guidance
A national endeavor issued by the
office of the US Surgeon General,
E-Cigarette Use Among Youth and
Young Adults, outlines 6 goals and
strategies to reduce e-cigarette
use among adolescents and young
adults.4 Strategies to accomplish
these goals encompass areas where
stakeholders (eg, individuals, par-
ents/caregivers, families, teachers,
coaches, youth influencers) can be-
come involved. One way parents can
engage is to become educated on the
risk of e-cigarette use, enabling the
parent/caregiver to educate their
own children about the harmful ef-
fects of e-cigarettes, other nicotine
products, and vaping of illicit sub-

stances. Being tobacco-free role
models, opening discussions about
the harms of tobacco and nicotine
products, and protecting young per-
sons from indirect exposure, such
as tobacco smoke or aerosol from
e-cigarettes, are illustrations.
Role of healthcare
providers
Lack of knowledge can be a result of
healthcare providers’ receiving lit-
tle or no formal training in either
their academic or practice settings
on screening, treating, or provid-
ing referrals to young patients and
their families in regard to vaping.
Healthcare providers may not even
be screening for the use these prod-
ucts. If asked about tobacco use, ado-

lescents and young adults who are us-
ing these products may not consider
them tobacco, and respond that they
are not using them. A recommenda-
tion would be to add vaping to the
electronic medical record’s tobacco
screening tool when screening for to-
bacco use in the pediatric population.
Healthcare providers can play a
key role both in clinical practice and
as faculty in higher education. The
provision of skills necessary to ad-
ICD-10 CODES
VAPING
The following are suggested
ICD-10 codes for the diagnosis
and treatment of tobacco/
nicotine use or abuse in

children. Check with your
contracted plan and individual
state Medicaid program for
coverage policy.
F17.290 Nicotine
dependence, other tobacco
product, uncomplicated
F17.298 Nicotine
dependence, other tobacco
product, with other nicotine-
induced disorders
F12.90 Cannabis use,
unspecified, uncomplicated
F12.10 Cannabis abuse,
uncomplicated
F12.21 Cannabis
dependence, in remission
T65.291A Toxic effect of
other tobacco and nicotine,
accidental (unintentional),
initial encounter (For children
who accidentally ingest a
liquid nicotine refill)
Z71.6 Tobacco abuse
counseling

Z72.0 Tobacco use
Z87.891 Personal history of
nicotine dependence
T 2 01732
peer-reviewed
dress the health and safety implica-
tions of pediatric nicotine use and
exposure needs to be incorporated
into clinical practicum course objec-
tives. Education initiatives in medical
and nursing practice can enhance the
ability to assess and synthesize data,
make clinical judgments, and initiate
diagnostics decisions. The develop-
ment of appropriate plans of care and
anticipatory guidance may be a sus-
tainable, long-term solution related to

this evolving public health epidemic.
Recommendations for
policy and practice
Regulatory policy lagged behind the
rapid revolution of e-cigarettes and
vaping resulting in risk to children, ad-
olescents, and young adults.13 In 2014,
the US Food and Drug Administration
(FDA) expanded regulatory authori-
ty under the Family Smoking Preven-
tion and Tobacco Control Act of 2009
to include all tobacco products includ-
ing e-cigarettes and hookahs.4,11 Con-
cerns by public health advocates exist
because the proposed regulations do
not include regulations of marketing
practices or flavored nicotine products
targeting young persons.13 E-cigarettes
presented a paradigm shift in the to-

bacco landscape. Vaping has gained
huge popularity among the younger
population and is an area wherein ex-
panded tobacco control policies and
enhanced surveillance of current and
emerging patterns of use are needed.4
Although recent regulations are
now restricting the sale of these
products to minors nationwide, the
marketing of these products in col-
ored refill packages and in a variety
of candy flavors is aimed at attract-
ing the younger generation with the
misperception of being a harmless
habit.9 Added hazards include a rise
in vaping other substances such as
the concoction of chemicals, canna-
bis, or synthetic drugs. Legalization of

medical marijuana and recreational
marijuana use in some states are rea-
sons rooted in escalating use of va-
porized cannabis use among youth.
Emerging patterns of alternative use,
such as dripping in 1 in 4 high school
students, support the need for regu-
lations and restrictions on e-cigarette
devices to avoid easy manipulation
for novel experimentation.8
Globally, taxation has been used
as an effective means to reduce ciga-
rette consumption. with approxi-
mately a 10% increase in price re-
sulting in a 1% decrease in smoking
prevalence.12 There is wide variabil-
ity in the taxation of non–cigarette
tobacco products in some markets

where ENDS have not been subject to
tobacco taxes. Consumers, particu-
larly adolescents, may seek more cost-
effective products, thus switching to
other tobacco products or substitut-
ing related ENDS. The FDA could
evaluate risk/exposure claims pro-
viding opportunities for tax advan-
tages to products as a way to draw
users away from more hazardous
products. Such regulations could also
bring about changes in non–cigarette
tobacco products that could impact
public health by reducing attractive-
ness and/or toxicity.
The New Jersey State Assembly and Senate are
reviewing a legislative bill (S298/A3704)14,15 to
ban all flavored electronic cigarette products.16

If the bill passes in both legislative houses and
is approved by Governor Chris Christie, the
opponents of the new law are concerned that
vape stores statewide would be out of business.17
This bill would expand on the 2008 New Jersey
law that already restricts the sale or distribution
of flavored electronic smoking devices,
cartridges, and liquid refills to adults, except
for 3 flavors: clove, menthol, or tobacco.16 The
current law also prohibits the sale or distribution
of electronic smoking devices to individuals aged
younger than 19 years, the same as cigarettes.17
Although many understand the marketing
concerns and potential health risks of vaping
as related to minors, the opponents of the bill
resent the limited sale of flavors to adults and
the potential impact on positive anecdotal
experiences of quitting traditional tobacco

products by vaping instead.17 Proponents of the
bill and public health advocates are concerned
these products are marketed toward young
persons and may increase the incidence of
tobacco use among children.
Despite the protests, the controversial bill
appears to be enduring the debate paralleling
antivaping legislation that is prevailing worldwide.
NEW JERSEY DEBATES
LEGISLATIVE BAN ON SALE
OF FLAVORED ELECTRONIC
SMOKING DEVICES
CONTINUED ON PAGE 38
T 2 01738
clinical brief
ment is believed to be inf lu-
enced by age, frequency of res-

piratory track infections, and social
factors such as daycare exposure. The
American Academy of Otolaryngol-
ogy–Head and Neck Surgery (AAO-
HNS) currently recommends tympa-
nostomy tube placement for children
with bilateral OME if they are aged
3 months and older and have hearing
difficulty, the study notes. Tube place-
ment also may be indicated in chil-
dren with unilateral or bilateral OME
if there are other symptoms present,
such as ear discomfort, vestibular
problems, and reduced quality of life
or school performance. Likewise, the
American Academy of Pediatrics sup-
ports tympanostomy tubes for chil-
dren who have experienced recurrent

AOM, with 3 episodes over 6 months or
4 episodes in a year.
In children with OME, researchers
found that mean hearing thresholds
increased by 9.1 decibels after tympa-
nostomy placement, and that tympa-
nostomy tubes, tympanostomy tubes
with adenoidectomy, and myringoto-
my with adenoidectomy were the most
effective interventions when it came
to hearing improvements. There were
no differences, however, in hearing
thresholds between children treated
with tympanostomy versus watchful
waiting after 1 to 2 years.
For long-term hearing improve-
ments, the research team found that
tympanostomy tube insertion with

adenoidectomy and myringotomy
with adenoidectomy were the 2 most
effective interventions, while tympa-
nostomy tubes alone, antibiotic pro-
phylaxis, and watchful waiting were
the least effective strategies.
For AOM, researchers compared
tympanostomy placement to a placebo
group and found that 3 of 20 children
in the placebo group had no further
episodes of AOM, while 12 in 22 who
received tympanostomy tubes were
without additional episodes after the
intervention. Another study analyzed
by the research team found that 40%
of children in a placebo group had no
further episodes of AOM compared
with 35% in the tympanostomy tube

group. Researchers noted, however,
that children in that study who were
treated with tympanostomy tubes had
a shorter duration of AOM episodes
than the placebo group.
Although evidence does support
short-term positive results, research-
ers note that the lack of long-term
hearing benefits between watchful
waiting and tube placement supports
the hypothesis of the preferred natu-
ral, spontaneous resolution of middle-
ear effusion that most children
experience.
Despite some limited evidence of
improved quality of life after tube
placement, neither of the 2 studies that
evaluated parental stress or health-re-

lated quality of life found a significant
difference between tympanostomy
tube placement and watchful waiting,
according to the researchers. Also,
adverse events were difficult to track
as they were not often reported, and
many cohorts did not follow up post–
tympanostomy tube placement until
the extrusion of the tube.
Researchers note that they were not
able to predict which children would
be most likely to benefit from tympa-
nostomy tube insertion for chronic
middle-ear effusion, although there
was evidence that tubes might be par-
ticularly effective in young children
attending daycare or in older children
with persistent hearing impairments

lasting more than 3 months.
Steele says his report does not offer
recommendations on when or if tubes
should be placed, but says the findings
are in line with recommendations al-
ready established by the AAO-HNS. He
says he hopes the report will encour-
age shared decision making between
parents and pediatricians.
Summary
There is the potential risk that public
misperceptions and regulatory prac-
tices do not often coincide with the
actual risk for tobacco products.12 The
pervasive tobacco control movement
based on strong science has been in-
strumental in driving numerous pol-
icy changes. Some of these positive
strategies include indoor smoking

restrictions, advertising bans aimed
at children, taxation (providing an
economic disincentive for smokers
to continue), and education. These
effective methods can inf luence
strategies regarding the use of non–
cigarette tobacco products that may
result in beneficial outcomes in pub-
lic health for the future.
Teen vaping CONTINUED FROM PAGE 32
For reference, go to
ContemporaryPediatrics.com/
tympanostomy-tubes
For references, go to
ContemporaryPediatrics.com/
teen-vaping
http://ContemporaryPediatrics.com/tympanostomy-tubes
http://ContemporaryPediatrics.com/teen-vaping

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Empowering people to do extraordinary thingsMRKT310.F1:
Consumer Behavior, Fall 2019
Course Information
Units
3
Prerequisites
MRKT 301 Principle of Marketing and MATH 226 Business
Statistics
Day/Time
Wed 9:00 – 11:30am
Classroom
SB201
Faculty Information
Instructor
Thuc-Doan Nguyen
Email
[email protected]
Office Hours
Wed 2:15 – 4:15pm, Thurs 5:30pm – 6:30pm
Office Location
School of Business Faculty Offices,
Room 107U
Attention: please log into Moodle at
http://go.woodbury.edubefore our first class meeting and
complete all pre-class work.
The pre-class assignments will be posted one week prior to the

start of classes.
Woodbury University Strategic Principles
Transdisciplinarity, Design Thinking, Entrepreneurship, and
Civic Engagement
School of Business
Cultivating Innovative Business Leaders for Sustainable Society
Woodbury University’s School of Business cultivates the
distinctive talents of each student to prepare future leaders of
business who communicate effectively, act ethically, and think
globally.Alignment with BBA Program Goals
This course is designed to support the following program
learning goals:
1. Communication
· Verbal: Give an effective presentation
· Written: Write effective business documents
In addition, we rely upon the other outcomes:
1. Ethical perspectives in professional decision-making
2. Global awareness
3. Leadership skills
4. Information LiteracyCatalog Description
This course is designed to provide understanding of the nature
and dynamics of consumer markets and their significance of the
marketing executive. To introduce the concepts and constructs
employed to identify and measure market segments and analysis
of behavioral patterns of these segments as a basis for
marketing strategy.
Course Learning Outcomes
Upon successful completion of the course, students will be able
to
1. Define and understand the dynamics of consumer behavior
and its relevance to marketing management
2. Comprehend the nature and complexity of the internal and
external influences upon consumer behaviors
3. Understand and analyze how consumer behavior is, can be, or
should be regulated,

4. Understand and analyze how consumer behavior impacts
society and how society impacts consumer behavior
5. Demonstrate awareness of global consumer culture.
6. Demonstrate awareness of ethical issues in consumer
behavior and analyze how these issues impact consumers,
corporations, society, and the world in general.
7. Apply analytical and critical thinking in consumer
behavior.Materials
1. Reading materials on Moodle
2. Consumer Behavior 8th Edition (2017) by Babin and Harris,
4LTR Press
Performance assessment and course grade break-down:
Exams 300
Exam I 150
Exam II 150
Behavior Change 200
Weekly log 75
Reflective paper 75
Group report 50
Term Project 350
FC 1 50
FC 2 75
FC 3 75
FC 4 150
Individual Participation 150
Total 1000
Course Requirement
Exams (300 points)
There will be two non-accumulative exams. They are written
exams.
Behavior Change (200 points)

The idea is to focus on consumer transformation. An important
part of this course is applying what you have learned to real
examples. You begin by selecting a behavior that you want to
change about yourself, such as stopping a harmful behavior,
(i.e. smoking, texting when driving, Excessive video-game
playing, or binge drinking) or small things (i.e. stop saying
sorry all the time, coming to class 5 minutes earlier), starting a
healthy behavior(i.e. an exercise program or changing what you
eat or drink) or starting/stopping a behavior related to
environment (turn off water tap when brushing your teeth,
recycling). You will engage in this change over a period of 4
weeks.
Individual work:
1) During the 4 weeks, you must log your attempt to change
your behavior (in narrative form, journal, number, visual
pictures etc.). You will have to submit your log weekly.
2) You will journal about what you have learned about your
behavior, applying concepts from the textbook and describing
the effects of your attempt to change your behavior. You will
write a minimum of two detailed paragraphs, first answering a
question about how your behavior is influenced by the topic and
second describing your behavior, any changes, and the results.
The paper length is one page double-space. You will also be
assigned to share your work with class. Grading is based on the
comprehensiveness of the entry and how well it incorporates CB
terms and concepts There will be a penalty for missing
deadlines of each week.
Group work:
1) Students then exchange their findings in groups, to analyze
similarities and differences, and then write the whole thing up
in a report after 4 weeks of change. Your report will address
following questions: What are common themes emerging from
your group data? What is the process of behavior change? What
are challenges? How do people face the challenges? What do
you learn about changing consumer behavior? (report due 2
weeks later).

Term project:Food Consumption (350 points)
The purpose of this project is to provide an opportunity to apply
what we’ve learned in class about consumers, consumer
research, and consumer behavior to promote healthy food
shopping and consumption. Specifically, you will have the
opportunity to collect secondary data, to practice observing
shoppers, to interview consumers, to analyze qualitative data,
and to suggest marketing tactics for improving the consumer
adoption of healthy food. These assignments will help us
address various questions related to the purchase and
consumption of food so that we can recommend marketing
tactics to expedite adaption to healthy food consumption.
Individual work:
· FC 1: Secondary data collection
· FC 2: Observation
· FC 3: Interview
Group work
· FC4: Data Analysis and Group Presentation
Class Participation (150 points)
Learning in this course will involve regular attendance to class,
contributing to any discussions in class and in small groups.
Much of what you will learn in this class comes from other
students sharing their own experiences and insights into
Consumer Behavior. Each student is encouraged to participate
in class discussions through: giving ideas, argument on case
analysis, asking the professor questions during lecture; break-
out exercises; and making public comments on other student
ideas/comments.
Class participation is critical to the success of the course since
the quality of the discussion is largely in your hands. Please
plan to attend all classes and to arrive ready for discussion. In
addition, please plan to stay for the entire class. Preparation is

important! Participation grades include
1) Reading the assigned articles and chapters; answering
assigned questions
2) Completing assignments and sharing with class
3) Participating in class discussion and activities
Your participation will be graded based on quality of your
assignments, quality and quantity of your contribution during
class discussion. Attendance does not equal
participation.Grading Criteria
A
94-100
A
Clearly stands out as excellent performance and, exhibits
mastery of learning outcomes.
A-
90-93
B+
87-89
B
84-86
B
Grasps subject matter at a level considered to be good to very
good, and exhibits partial mastery of learning outcomes.
B-
80-83
C+
77-79

C
74-76
C
Demonstrates a satisfactory comprehension of the subject
matter, and exhibits sufficient understanding and skills to
progress in continued sequential learning.
C-
70-73
D+
67-69
D
60-66
D
Quality and quantity of work is below average, exhibits only
minimal understanding and skills are not sufficient to continue.
F
0-59
F
Quality and quantity of work is below average and not
sufficient to progress.
Instructional Methodology
Lectures, videos, case studies, guest speakers, written
assignments, quizzes, film screenings.
Attendance Policy
The School of Business has standardized a school-wide
attendance policy. Below is the official policy.
Absence and tardiness policy:

In the School of Business we believe in preparing our students
for workplaces in which discipline and participation are
considered part of their performance. We therefore expect our
students to attend all class meetings, because the dialogues,
presentations, and lectures are critical and cannot be substituted
by mere textbook readings and test submissions. As is often the
case in the corporate setting, learning happens by being there:
through listening, sharing, asking, and other means of
constructive communication.
Please find below our policy on absences and tardiness:
· In once-a-week traditional courses, students will experience a
course grade reduction after missing 2 class sessions. After the
second absence, their grade will drop a full letter grade
(equivalent to 1 missed session in a 7-week course). If more
than 3 sessions are missed, the student will be either required to
withdraw or will be dropped one letter grade for each additional
absence from then on.
· All traditional-format courses, sessions missed during the
add/drop period count as absences.
· Tardiness policy: every 2 late attendances as the equivalence
of 1 absence.
· Special circumstances will be dealt with on a case-by-case
basis.
Other Policies
1. Academic Honesty
Assignments you turn in in are to be done by you alone, and
your hands must be on the keyboard. Submitting work
completed by another student will result in a reduced or failing
final grade. Making your work available to other students for
them to cheat with it will also result in a penalty for you. It is
ok to ask for feedback from another student or for help with

generating ideas, etc., but it is not ok to have someone else tell
you step-by-step to complete an assignment.
2. Disabilities
This class will adhere to the following standard Woodbury
policy on disabilities.
Woodbury University is committed to making reasonable
accommodations to assist individuals with disabilities in
reaching their academic potential. Students desiring
accommodations due to a physical, learning or psychological
disability must first complete an Accommodations Request
Form, which can be downloaded from http://go.woodbury.edu,
and found under “Academic Resources.” Accommodations
cannot be granted prior to the instructor’s receipt of a
Notification of Special Needs Release Form from the
Disabilities Coordinator. Accommodations are never provided
retroactively. (For more information, contact the Disabilities
Coordinator in the Whitten Center (818) 394-3345.)
3. Assignment submission:
Assignments must be submitted on Moodle as well as hard copy
in class. Assignments are expected to be completed by due date.
Assignments submitted 4 days after the due date will not be
accepted. For every day the assignment is late after due date,
10% will be deducted from the assignment score.
4. Moodle
Students must check Moodle for announcement and updates on
class
5. Subject to change
This syllabus is provisional and subject to change
Tentative Class Schedule

Week
Date
Chapter
Activities
Week 1
Aug. 21
Topic:
· What Is CB?
· Business Ethics and Consumer Rights
· Introduce “Behavior change” assignment
Pre-assignment: Create a collage (a set of 5-6
photographs/pictures) of things you have or do that are central
to who you are, including a picture of yourself. The collage’s
size is at least as large as A3 size (11.69 x 16.54 inches).
2
Aug 28
Identifying, understanding and talking to your consumer
How do we study consumer behavior?
Read “The planning and implementation of integrated marketing
communications.” Caemmerer (2009)
Read: Laddering white paper
https://rockresearch.com/understanding-consumer-decision-
making-with-means-end-research
3
Sep 4
Topic: Creating Customer Value
Introduce Term Project
Behavior Change Week 1
Read: Creating customer value (1. Introduction, 2.1 – 2.2 -2.3 –
2.4)
Prepared questions: Type your answers
1. What is economic value to customers?
2. What is functional value to customers?

3. What is experiential value to customers?
4. What is social value to customers?
Pre-assignment: Choose one of your consumption activities as
example and analyze
1. How marketers create experiential value and/or emotional
benefits for you (that is, via design, branding, customer service)
2. How marketer create social value?
4
Sep 11
Research Method:
· Secondary Data
· Observation
Due: Behavior Change- weekly log 1
5
Sep 18
Topic: Customer Perception
Topic: Perceptual Map
Due:
· Behavior Change - weekly log 2
· FC 1: Secondary data
Reading:
· Chapter 3
6
Sep 25
Topic: Motivation and Emotion
Due: Behavior Change - weekly log 3
Reading:
· The new science of customer emotions
· chapter 5: 5-1 and 5-2

7
Oct 2
· Exam 1
Due: Behavior Change- weekly log 4
· FC 2: Observation
8
Oct 9
Research Method: Interview
Topic: Attitude and changing attitude
Due: Behavior Change-Reflective Paper due
Reading:
· Chapter 7
9
Oct 16
Topic: Attitude and changing attitude
Topic: Identity and Consumption
Due:
· Behavior Change - Report
Reading:
· Chapter 6
· Possessions and the Extended Self, Belk (1988)
10
Oct 23
· Personality
· Self-Concept
Research Method: Data Analysis
Due:
· FC 3
11
Oct. 30
Topic: Buying Process

Reading:
· Chapter 12
· Chapter 13
12
Nov 6
Topic: Buying Process
13
Nov 13
Topic: Consumers and Cultures
Reading:
Chapter 9
14
Nov 20
Exam 2
15
Nov 27
Work on Group Project
16
Dec. 11
Project Presentation
FC 4 due
MRKT310 Syllabus – Page 7

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