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Liao LL, Chang LC, Lee CK, Lai IJ. College students' perceptions of electronic cigarette risks and benefits: a concept mapping study. HEALTH EDUCATION RESEARCH 2024; 39:398-408. [PMID: 38776131 DOI: 10.1093/her/cyae019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 04/17/2024] [Accepted: 05/09/2024] [Indexed: 07/20/2024]
Abstract
The use of electronic cigarettes (e-cigarettes) is on the rise among young adults, with higher public acceptance than traditional tobacco. A study in Taiwan employed concept mapping to explore risk and benefit perceptions of e-cigarette use among college students. The study involved 100 college students from 11 Taiwanese universities, with 50 being e-cigarette users and 50 non-users. Data collection and analysis were done with the GroupWisdom™ platform. Participants engaged in brainstorming, rating and sorting their perceptions, which were analyzed using multidimensional scaling and hierarchical cluster analyses. The participants' mean age was 19.24 years, and 55% were male. This process resulted in the identification of 10 clusters encompassing 64 statements, with 3 clusters focused on risk perceptions, 6 on benefit perceptions, and 1 dealing with e-cigarette regulations. Notably, risk perceptions were rated higher than benefit perceptions. Non-users held significantly higher risk perceptions and lower benefit perceptions across the nine clusters related to e-cigarette use. Concept mapping proved to be an effective tool for understanding college students' perceptions. These findings can assist health educators in comprehending college students' viewpoints on e-cigarette use and in developing targeted interventions. Additionally, exploring benefit perceptions may enhance students' critical thinking skills regarding e-cigarette advertising.
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Affiliation(s)
- Li-Ling Liao
- Department of Public Health, College of Health Science, Kaohsiung Medical University, No. 100, Shih-Chuan 1st Road, Sanmin Dist., Kaohsiung City 80708, Taiwan
- Department of Medical Research, Kaohsiung Medical University Hospital, No. 100, Tzyou 1st Road, Sanmin Dist., Kaohsiung City 80756, Taiwan
| | - Li-Chun Chang
- Department of Nursing, Chang Gung University of Science and Technology, No. 261, Wen-Hua 1st Road, Guishan Dist., Taoyuan City 33303, Taiwan
| | - Chia-Kuei Lee
- Department of Nursing, College of Medicine, National Cheng Kung University, No. 1, University Road, East Dist., Tainan City 70101, Taiwan
| | - I-Ju Lai
- Department of Nutrition, I-Shou University, No. 8, Yida Road, Jiaosu Village Yanchao Dist., Kaohsiung City 82445, Taiwan
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Molla Legesse S, Wondimu H. Development and Validation of the Amharic Version of Self-Efficacy and Outcome Expectancy Measures on Intention to Take Preventive Actions on Noncommunicable Disease. Behav Neurol 2023; 2023:6669157. [PMID: 37942275 PMCID: PMC10630007 DOI: 10.1155/2023/6669157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 09/23/2023] [Accepted: 10/10/2023] [Indexed: 11/10/2023] Open
Abstract
This study is aimed at developing and accessing the validity and reliability of an Amharic version of the self-efficacy and outcome expectancy measures on noncommunicable disease prevention strategies. The intentions to take protective measures on NCDs' self-efficacy and outcome expectancy scales were created in Amharic using a sequential nine-step process that included translation and contextualization of the items, content validity, pretesting of the questions, sampling, and survey administration. Principal component analysis was conducted on 829 university students which showed a one-factor solution for self-efficacy and a three-factor solution for outcome expectancy scales using split-half measures. Confirmatory factor analyses supported the factor structure, which also demonstrated good internal consistency (.828 self-efficacy, .766 outcome expectancy). The scales had a moderate level of correlation (r = .35, p.001) between them. The study resulted in reliable and valid Amharic versions of self-efficacy (9-item) and outcome expectancy (12-item) scales.
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Affiliation(s)
- Shumye Molla Legesse
- Department of Psychology, College of Social Sciences and Humanities, Debre Birhan University, Ethiopia
| | - Habtamu Wondimu
- School of Psychology, College of Education and Behavioral Studies, Addis Ababa University, Ethiopia
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Soule EK, Sousan S, Pender J, Thomas L, Gold E, Fresquez S, Mooring R, Coombs V, Gogineni A, Tiet A. Secondhand electronic cigarette aerosol in vehicles impacts indoor air quality. Drug Alcohol Depend 2023; 250:110889. [PMID: 37478503 PMCID: PMC10528711 DOI: 10.1016/j.drugalcdep.2023.110889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 06/26/2023] [Accepted: 07/04/2023] [Indexed: 07/23/2023]
Abstract
BACKGROUND Electronic cigarette (ECIG) use in vehicles represents a public health concern due to the potential for exposure to high concentrations of particulate matter (PM) and other toxicants. This study examined the impact of ECIG use on air quality in vehicles. METHODS People who reported current ECIG use (n=60; mean age=20.5, SD=2.3) completed a brief survey and a 30-min ECIG use session in their own vehicle. Using a protocol similar to clinical laboratory studies involving tobacco use, participants took 10 directed puffs (i.e., a directed bout with one puff every 30s for 5min) followed by a 25-min ad libitum period in which participants took as many puffs as desired. PM 2.5µm in diameter or smaller (PM2.5) were measured using aerosol monitors set up to sample air from the breathing zone of the passenger seat and total puffs were recorded. The association between peak PM2.5 concentration and puff count was examined. RESULTS Participants took a median 18 total puffs during the sessions. Median PM2.5 concentrations increased from 4.78µg/m3 at baseline to 107.40µg/m3 after the directed bout. Median peak PM2.5 concentration was 464.48µg/m3 and ranged from 9.56µg/m3 to 143,503.91µg/m3 (IQR=132.72-1604.68). After removing two extreme outliers for puff count and PM2.5 concentrations, puff count was significantly correlated with peak PM2.5 concentration during the ad libitum bout (r=0.32, p=0.015). CONCLUSIONS ECIG use in vehicles impacts air quality negatively and may pose health risks to those present in vehicles when ECIG use is occurring.
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Affiliation(s)
- Eric K Soule
- Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, Greenville, NC27858, USA; Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA27858, USA.
| | - Sinan Sousan
- Department of Public Health, Brody School of Medicine, East Carolina UniversityGreenville, NC27858, USA; North Carolina Agromedicine Institute, Greenville, NC27858, USA
| | - Jack Pender
- Department of Chemistry, Thomas Harriot College of Arts & Sciences, East Carolina University, Greenville, NC27858, USA
| | - Luke Thomas
- Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, Greenville, NC27858, USA
| | - Emily Gold
- Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, Greenville, NC27858, USA
| | - Sarah Fresquez
- Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, Greenville, NC27858, USA
| | - Ronald Mooring
- Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, Greenville, NC27858, USA
| | - Vivien Coombs
- Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, Greenville, NC27858, USA
| | - Anish Gogineni
- Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, Greenville, NC27858, USA
| | - Alex Tiet
- Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, Greenville, NC27858, USA
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Soule EK, Sousan S, Pender J, Thomas A, Patel N. Electronic cigarette use and cigarette smoking in vehicles among adults who use electronic cigarettes and cigarettes in the USA. Tob Control 2023:tc-2022-057898. [PMID: 37451861 PMCID: PMC10787805 DOI: 10.1136/tc-2022-057898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 06/28/2023] [Indexed: 07/18/2023]
Affiliation(s)
- Eric K Soule
- Department of Health Education and Promotion, East Carolina University, Greenville, North Carolina, USA
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Sinan Sousan
- Department of Public Health, East Carolina University, Greenville, North Carolina, USA
- North Carolina Agromedicine Institute, Greenville, North Carolina, USA
| | - Jack Pender
- Department of Chemistry, East Carolina University, Greenville, North Carolina, USA
| | - Alisha Thomas
- Department of Health Education and Promotion, East Carolina University, Greenville, North Carolina, USA
| | - Neal Patel
- Department of Health Education and Promotion, East Carolina University, Greenville, North Carolina, USA
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Santhidran S, Periyayya T, Mastor KA, Idris IB. Does Quit Smoking Desire Influence E-Cigarette Smoking Behaviour? Malaysian Perspectives. Malays J Med Sci 2023; 30:195-201. [PMID: 37425392 PMCID: PMC10325133 DOI: 10.21315/mjms2023.30.3.18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Accepted: 10/30/2022] [Indexed: 07/11/2023] Open
Abstract
Recent years have witnessed an emerging trend of e-cigarette smoking in Southeast Asia. On the basis of Malaysian perspectives, this cross-sectional study explored the relationship between e-cigarette smoking behaviour and variables such as perceived health benefit, the desire to quit, social acceptance, social impact and product usefulness. Individuals aged 17 years old and older were recruited via purposive convenience sampling, yielding a total sample of 503 respondents. Collected data were analysed via partial least squares-structural equational modelling. The results showed that perceived heath benefit (β = 0.19, P < 0.01), social acceptance (β = 0.23, P < 0.01) and social impact (β = 0.49, P < 0.01) positively influence e-cigarette smoking behaviour. No such effect is exerted by the desire to quit smoking (β = 0.08, P < 0.05) and product usefulness t (β = -0. 10, P < 0.05). Future studies should examine whether demographic variables affect e-cigarette smoking behaviour.
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Affiliation(s)
- Sinnappan Santhidran
- Department of Mass Communication, Universiti Tunku Abdul Rahman, Selangor, Malaysia
| | - Thinavan Periyayya
- Department of Mass Communication, Universiti Tunku Abdul Rahman, Selangor, Malaysia
| | - Khairul Anwar Mastor
- Pusat Pengajian Citra Universiti, Universiti Kebangsaan Malaysia, Selangor, Malaysia
| | - Idayu Badilla Idris
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Selangor, Malaysia
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Enlow PT, Felicione N, Williford DN, Durkin K, Blank MD, Duncan CL. Validation of the Electronic Cigarette Expectancy Scale for Adolescents. Subst Use Misuse 2021; 57:212-221. [PMID: 34796784 PMCID: PMC9109109 DOI: 10.1080/10826084.2021.2002898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Expectancies of costs and benefits can be predictive of tobacco use, as well as cessation attempts and success. Measuring electronic cigarette (ECIG) expectancies is in its infancy, particularly among adolescents. However, the popularity of adolescent ECIG use demonstrates the need to understand better these contributing factors. Our aim was to evaluate the factor structure and initial psychometric properties of an ECIG expectancies questionnaire adapted from an existing validated scale for conventional cigarette smoking (Smoking Expectancy Scale for Adolescents; SESA). METHODS Five-hundred sixty-nine adolescents (14-18 years; 60.1% female; 84.1% White) were recruited from high schools and an adolescent medicine clinic. Participants completed a battery of self-report measures, including the ECIG Expectancies Scale for Adolescents (EESA). Exploratory factor analyses were used to examine the underlying factor structure, and convergent validity was evaluated using variables conceptually related to ECIG expectancies. RESULTS A three-factor solution was chosen based on statistical evidence and conceptual relevance. All three factors - Costs, Social Benefits, and Affective/Weight Benefits - had strong internal consistencies and demonstrated convergent validity via significant associations with peer ECIG use and Conscientiousness. The Costs and Affective/Weight Benefits factors also demonstrated convergent validity with sensation-seeking, intention to use ECIGs, and ECIG use status (current, lifetime, nonuser). CONCLUSION Results support the initial reliability and validity of the EESA scores. This factor structure is related to, yet different from, that observed not only for the SESA but also for other ECIG-expectancy measures among adult populations.
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Affiliation(s)
- Paul T. Enlow
- Center for Healthcare Delivery Science, Nemours Children’s Health System
- Department of Pediatrics, Sidney Kimmel Medical College of Thomas Jefferson University
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Amin S, Dunn AG, Laranjo L. Why do people start or stop using e-cigarettes in Australia? A qualitative interview-based study. Health Promot J Austr 2020; 32 Suppl 2:358-366. [PMID: 33251638 DOI: 10.1002/hpja.442] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 11/24/2020] [Indexed: 11/08/2022] Open
Abstract
ISSUE ADDRESSED E-cigarette awareness and use has increased globally, but little is known about the social factors that influence uptake in Australia. We explored the reasons why people started, continued and stopped using e-cigarettes in Australia. METHODS This was a qualitative study comprising 14 semi-structured interviews with past and current e-cigarette users in Australia. Interview transcripts were analysed thematically to explore reasons why people started, continued or stopped using e-cigarettes. RESULTS The following three themes emerged from interviews: "social" reasons, including issues of peer influence and social norms; "health" reasons, with aspects related to the reduction in use of cigarettes and health effects of using e-cigarettes; and "access and other personal" reasons, including the cost of e-cigarettes, the ability to access e-cigarettes and participants' experiences with e-cigarettes. CONCLUSIONS The study revealed that social norms and peer influence were reasons why people started and stopped using e-cigarettes. Smokers often cited health reasons for starting, while non-smokers cited social reasons for both starting and stopping. SO WHAT?: The social and non-social reasons for why people say they start or stop using e-cigarettes appear to vary between smokers and non-smokers. Future studies may benefit from measuring these factors, differentiating between smokers and non-smokers, and considering these factors as part of interventions for limiting e-cigarette uptake among non-smokers.
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Affiliation(s)
- Samia Amin
- Centre for Health Informatics, Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia
| | - Adam G Dunn
- Discipline of Biomedical Informatics and Digital Health, School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Liliana Laranjo
- Centre for Health Informatics, Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia
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DiPiazza J, Caponnetto P, Askin G, Christos P, Maglia MLP, Gautam R, Roche S, Polosa R. Sensory experiences and cues among E-cigarette users. Harm Reduct J 2020; 17:75. [PMID: 33059666 PMCID: PMC7559939 DOI: 10.1186/s12954-020-00420-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 09/26/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND AND AIMS We characterized the extent and quality of respiratory sensations and sensory-related smoking cues associated with e-cigarette use among those who failed to quit combustible tobacco cigarette (CTC) use with traditional FDA approved medications but succeeded in doing so with e-cigarettes. Further, we sought to understand former smokers' perceptions about the influence of sensory experience with e-cigarette use on CTC cessation outcomes. METHODS A nonrandom purposive sample of 156 participants recruited in the USA through the Consumer Advocates for Smoke Free Alternatives Association Facebook page completed an online cross-sectional survey to assess sensory experiences and smoking cues associated with e-cigarette use. Descriptive statistics were calculated, and the ANOVA/Kruskal-Wallis test with post hoc testing and the two-sample t test/Wilcoxon rank-sum test, as appropriate based on distribution, were used to assess the association between sample characteristics and sensory experiences and cues using investigator constructed questions, the Modified Cigarette Evaluation Questionnaire (mCEQ) and the Smoking Cue Appeal Survey (SCAS). RESULTS With e-cigarette use, participants reported feeling the vapor in their throats, windpipes, noses, lungs, and on their tongues; reductions in nicotine craving; and enjoyment of their e-cigarette, including tasting, smelling, and seeing the vapor and touching the device. Women had greater craving reduction than men (p = 0.023). Those who began smoking at 13 years of age or younger had more satisfaction and had greater sensory enjoyment than those who began smoking at 16-17 years of age (p = 0.015 and p = 0.026, respectively), as well as greater sensory enjoyment than those who began smoking at 14-15 years of age (p = 0.047). There was a significant overall association between the number of years a respondent smoked and e-cigarette sensory enjoyment (p = 0.038). Participants 18-34 years old rated e-cigarettes as being more pleasant compared to 45 + years olds, (p = 0.012). Eighty-four percent of participants reported the sensation of the vapor as important in quitting CTCs, and 91% believed the sensations accompanying e-cigarette use contributed to their smoking cessation success. CONCLUSIONS For those who failed to quit previously using approved cessation medications to stop smoking cigarettes, sensory experiences associated with e-cigarette use may help smokers quit smoking.
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Affiliation(s)
- J DiPiazza
- Hunter Bellevue School of Nursing, Hunter College-City University of New York, New York, NY, USA
| | - P Caponnetto
- Centro per la Prevenzione e Cura del Tabagismo (CPCT), Azienda Ospedaliero-Universitaria "V.Emanuele-Policlinico", Università di Catania, Catania, Italy.
- Institute of Internal Medicine, Azienda Ospedaliero-Universitaria "Policlinico V. Emanuele", Università di Catania, Catania, Italy.
- Institute for Social Marketing, University of Stirling, Stirling, FK9 4LA, UK.
| | - G Askin
- Division of Biostatistics and Epidemiology, Department of Healthcare Policy and Research, Weill Cornell Medicine, New York, NY, USA
| | - P Christos
- Division of Biostatistics and Epidemiology, Department of Healthcare Policy and Research, Weill Cornell Medicine, New York, NY, USA
| | - M Lyc Psych Maglia
- Centro per la Prevenzione e Cura del Tabagismo (CPCT), Azienda Ospedaliero-Universitaria "V.Emanuele-Policlinico", Università di Catania, Catania, Italy
| | - R Gautam
- Clinical and Translational Science Center, Weill Cornell Medicine, New York, NY, USA
| | - S Roche
- Hunter Bellevue School of Nursing, Hunter College-City University of New York, New York, NY, USA
| | - R Polosa
- Centro per la Prevenzione e Cura del Tabagismo (CPCT), Azienda Ospedaliero-Universitaria "V.Emanuele-Policlinico", Università di Catania, Catania, Italy
- Institute of Internal Medicine, Azienda Ospedaliero-Universitaria "Policlinico V. Emanuele", Università di Catania, Catania, Italy
- Center of Excellence for the Acceleration of Harm Reduction (CoEHAR), University of Catania, Catania, Italy
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
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Impacts of COVID-19 on Electronic Cigarette Purchasing, Use and Related Behaviors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17186762. [PMID: 32948084 PMCID: PMC7558653 DOI: 10.3390/ijerph17186762] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 09/11/2020] [Accepted: 09/14/2020] [Indexed: 02/06/2023]
Abstract
Background: COVID-19 has caused health impacts and disruptions globally. Electronic cigarette (ECIG) users may face additional impacts. This study examined impacts of COVID-19 on ECIG users. Methods: Concept mapping, a mixed-methods approach, was used to identify COVID-19 impacts on adult ECIG users. ECIG users (n = 93) provided statements completing a prompt: "A specific way Coronavirus/COVID-19 has affected my vaping/e-cigarette use, my vaping/e-cigarette related purchasing, or other vaping/e-cigarette related behaviors or issues is…". Participants generated 85 unique statements, sorted statements into groups of similar content and rated each statement on how true they were. Multidimensional scaling and hierarchical cluster analysis identified thematic clusters. Mean cluster ratings were compared between sample subgroups. Results: Ten clusters were identified: Stocking up and Bulk Purchasing, Challenges in Obtaining ECIG Supplies, Alternative Purchasing Procedures, Increased ECIG use, Disruption of Routine and ECIG Use, Efforts to Decrease ECIG Use, Improving ECIG Skills, COVID-19 Health Concerns, Perceptions of ECIG Use and COVID-19, and COVID-19 Protection. More dependent ECIG users and dual users of ECIGs and cigarettes rated clusters higher than less dependent ECIG users and non-dual users. Conclusions: ECIG users may experience or perceive they face additional COVID-19 impacts, such as increased exposure, financial burdens, stress, and health risks.
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Psychometric Properties of Turkish Version of the E-Cigarette Use Outcome Expectancies Scale. J Addict Nurs 2020; 31:124-133. [PMID: 32487939 DOI: 10.1097/jan.0000000000000338] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVE This study was carried out to evaluate the validity and reliability of the E-Cigarette Use Outcome Expectancies Scale (EUOES) in the Turkish context. METHOD The sample for the study was composed of 1,725 first-, second-, third-, and fourth-year university students aged 18-25 years. The data from the study were collected using a sociodemographic data collection form and the EUOES. Numbers and percentages were used for the evaluation of the data. In addition, content validity index, Pearson's correlation analysis, a paired samples t test, Cronbach's alpha coefficient, and exploratory and confirmatory factor analyses were employed for the analysis of language validity and expert opinions. FINDINGS As a result of the confirmatory factor analysis, the factor loadings of the scale were found to range from 0.450 to 0.939. The confirmatory factor analysis revealed that the fit indices of the scale were 0.90 and higher. Cronbach's alpha coefficient of the scale was determined as .86. CONCLUSION As a result of the analysis, the EUOES was found to be a valid and reliable measurement tool for the Turkish sample.
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Soule EK, Lee JGL, Egan KL, Bode KM, Desrosiers AC, Guy M, Breland A, Fagan P. "I cannot live without my vape": Electronic cigarette user-identified indicators of vaping dependence. Drug Alcohol Depend 2020; 209:107886. [PMID: 32061946 PMCID: PMC7330178 DOI: 10.1016/j.drugalcdep.2020.107886] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 01/17/2020] [Accepted: 01/21/2020] [Indexed: 01/06/2023]
Abstract
BACKGROUND Limited research has examined indicators of electronic cigarette (ECIG) dependence. Researchers have adapted ECIG dependence measures from cigarette smoking dependence measures, but few have examined unique aspects of ECIG dependence. This study used concept mapping, a mixed-methods approach to examine ECIG user-identified indicators of ECIG dependence. METHODS In 2019, we recruited current ECIG users (n = 75; 52.9 % women; mean age = 33.2, SD = 9.9) from 25 states to complete an online study. Participants completed a brief survey and brainstormed statements (n = 216) completing the prompt: "Something specific that makes me think I am addicted to using my electronic cigarette/vaping device is…" After duplicate content was removed, participants sorted the final list of 93 statements by content similarity and rated statements on how true statements were for them (1 - Definitely NOT true to 7 - Definitely true). Multidimensional scaling analysis identified ECIG dependence thematic clusters. RESULTS We identified ten themes: Craving, Negative Affect, Vaping as a Necessity, Therapeutic Effects, Preparedness, Attachment to Device, Impact on Daily Activity, Physical Withdrawal Symptoms, Monetary Cost, and Shame or Embarrassment. Those who had higher ECIG dependence scores and those who reported more frequent ECIG use had higher mean cluster ratings than those with lower ECIG dependence scores and who reported less frequent ECIG use. (ps<.05). CONCLUSIONS ECIG dependence has similarities to cigarette smoking dependence, but dependence indicators appear to be unique to ECIG use. Health professionals and the public should be aware of ECIG dependence risk and indicators.
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Affiliation(s)
- Eric K. Soule
- Department of Health Education and Promotion, College of Health and Human Performance, Mail Stop 529, East Carolina University, 1000 East 1 Street, Greenville, NC 27858 USA,Center for the Study of Tobacco Products, Virginia Commonwealth University, 100 W Franklin St., Suite 200, Richmond, VA 23220 USA
| | - Joseph G. L. Lee
- Department of Health Education and Promotion, College of Health and Human Performance, Mail Stop 529, East Carolina University, 1000 East 1 Street, Greenville, NC 27858 USA,Cancer Prevention and Control, UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC
| | - Kathleen L. Egan
- Department of Health Education and Promotion, College of Health and Human Performance, Mail Stop 529, East Carolina University, 1000 East 1 Street, Greenville, NC 27858 USA
| | - Kendall M. Bode
- Department of Health Education and Promotion, College of Health and Human Performance, Mail Stop 529, East Carolina University, 1000 East 1 Street, Greenville, NC 27858 USA,Cancer Prevention and Control, UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC
| | - Abigail C. Desrosiers
- Department of Health Education and Promotion, College of Health and Human Performance, Mail Stop 529, East Carolina University, 1000 East 1 Street, Greenville, NC 27858 USA,Cancer Prevention and Control, UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC
| | - Mignonne Guy
- Center for the Study of Tobacco Products, Virginia Commonwealth University, 100 W Franklin St., Suite 200, Richmond, VA 23220 USA,Department of African American Studies, College of Humanities and Sciences, Virginia Commonwealth University, PO Box 842509, Richmond, VA 23284 USA
| | - Alison Breland
- Center for the Study of Tobacco Products, Virginia Commonwealth University, 100 W Franklin St., Suite 200, Richmond, VA 23220 USA; Department of Psychology, College of Humanities and Sciences, Virginia Commonwealth University, Richmond, VA 100 W Franklin St., Suite 200, Richmond, VA 23220 USA.
| | - Pebbles Fagan
- Center for the Study of Tobacco Products, Virginia Commonwealth University, 100 W Franklin St., Suite 200, Richmond, VA 23220 USA; Department of Health Behavior and Health Education, Fay W. Boozman College of Public Health, Center for the Study of Tobacco, University of Arkansas for Medical Sciences, 4301 West Markham, # 820, Little Rock, AR 72205 USA.
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Hiler M, Spindle TR, Dick D, Eissenberg T, Breland A, Soule E. Reasons for Transition From Electronic Cigarette Use to Cigarette Smoking Among Young Adult College Students. J Adolesc Health 2020; 66:56-63. [PMID: 31699605 PMCID: PMC6935466 DOI: 10.1016/j.jadohealth.2019.09.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 09/04/2019] [Accepted: 09/05/2019] [Indexed: 02/06/2023]
Abstract
PURPOSE Longitudinal studies indicate that e-cigarette use among youth and young adults is associated with cigarette smoking initiation. The purpose of this study was to identify reasons why nonsmoking young adults transition from e-cigarette use to cigarette smoking. METHODS The study used concept mapping (CM), a mixed-method participatory approach. Fifty-five college students who endorsed initiation of e-cigarettes before cigarettes (lifetime e-cigarette uses ≥ 100 and ≥ 100 cigarettes in lifetime) completed at least one part of the study. In an online program, participants brainstormed (n = 54) statements describing reasons for transition from e-cigarette use to cigarette smoking, sorted statements (n = 46) into conceptually similar categories, and rated (n = 47) how true each statement was for them. RESULTS Participants generated 60 unique statements, and multidimensional scaling analysis generated eight thematic clusters characterizing reasons for transition which included the following: "Sharing with Others," "Psychological Coping," "Cigarette Appeal," "Reinforcing Effects of Cigarettes," "Accessibility," "Social Influence," "Vaping Stigma," and "Vaping Deficiencies." Participants rated "Sharing with Others" and "Psychological Coping" highest (most true) and "Vaping Deficiencies" lowest (least true). For college students, the ability to share cigarettes with peers and access cigarettes from peers and smoking for stress/anxiety management were among the top reasons for transition. CONCLUSIONS Results suggest that tailored prevention efforts aimed at reducing cigarette smoking uptake among college students who use tobacco as a means for psychological coping or social facilitation may be warranted. Furthermore, regulatory decisions aimed at limiting cigarette appeal, reinforcing effects, and accessibility may be relevant to reducing transition.
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Affiliation(s)
- Marzena Hiler
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia; Department of Psychology, Virginia Commonwealth University, Richmond, Virginia.
| | - Tory R Spindle
- Behavioral Pharmacology Research Unit, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Danielle Dick
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia; Department of Human and Molecular Genetics, Virginia Commonwealth University, Richmond, Virginia
| | - Thomas Eissenberg
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia; Department of Psychology, Virginia Commonwealth University, Richmond, Virginia
| | - Alison Breland
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia; Department of Psychology, Virginia Commonwealth University, Richmond, Virginia
| | - Eric Soule
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia; Department of Health Education and Promotion, East Carolina University, Greenville, North Carolina.
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Palmer AM, Brandon TH. Nicotine or expectancies? Using the balanced-placebo design to test immediate outcomes of vaping. Addict Behav 2019; 97:90-96. [PMID: 31174168 DOI: 10.1016/j.addbeh.2019.04.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 04/23/2019] [Accepted: 04/25/2019] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Electronic (e-)cigarette use has increased in popularity, especially among those attempting to quit smoking. Previous studies evaluating the therapeutic efficacy of e-cigarettes have suggested that non-pharmacologic factors, such as expectancies about nicotine effects, may influence the experienced effects of e-cigarettes. METHOD The independent and synergistic influences of drug and expectancies were parsed using a balanced-placebo design, whereby 128 participants (52 dual users) were provided an e-cigarette that either contained nicotine or non-nicotine solution, while told that it did or did not contain nicotine. We hypothesized main effects of nicotine content on physiological, objective outcomes (attention, appetite, aversion, respiratory tract sensations), and main effects of the instructions on more subjective, psychosocial outcomes (affect, reward, satisfaction). Sex was included as a moderator. RESULTS Results showed that nicotine increased sustained attention, and more so among females. Nicotine delivery was associated with aversion among females, but not males. Among those who were both told and did not receive nicotine, higher enjoyment of respiratory tract sensations was reported. Nicotine with complementary instructions produced the highest reward ratings; additionally, nicotine was rewarding to males but not females. DISCUSSION Findings demonstrated that both nicotine content and non-pharmacologic factors impact acute outcome effects of e-cigarettes, with moderation by sex in some cases. Results are relevant to the interpretation of clinical trials of e-cigarettes and suggest a more nuanced view of reinforcement pathways.
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Harrell PT, Brandon TH, England KJ, Barnett TE, Brockenberry LO, Simmons VN, Quinn GP. Vaping Expectancies: A Qualitative Study among Young Adult Nonusers, Smokers, Vapers, and Dual Users. Subst Abuse 2019; 13:1178221819866210. [PMID: 31456638 PMCID: PMC6702779 DOI: 10.1177/1178221819866210] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 07/05/2019] [Indexed: 11/16/2022]
Abstract
BACKGROUND "Expectancies," or beliefs about outcomes, robustly correlate with and predict several behaviors including electronic nicotine delivery system ("e-cigarette") use. However, there is limited qualitative research available regarding relevant e-cigarette vaping expectancies. OBJECTIVES The present study used a qualitative approach to derive and refine e-cigarette expectancy themes among young adults. METHODS We conducted 12 focus groups and two individual interviews with young adult nonusers, e-cigarette vapers, cigarette smokers, and dual users to assess beliefs about the effects of e-cigarettes. After a series of open-ended questions, follow-up questions assessed reactions to domains previously examined in expectancy measures for cigarette smoking and e-cigarette vaping. The constant comparative method was used to derive themes from transcripts. RESULTS Four main themes (Positive Reinforcement, Social Benefits, Negative Affect Reduction, Negative Consequences) emerged from the results. Each theme contained three associated subthemes (Positive Reinforcement: Sensorimotor Experiences, Taste, Stimulation; Social Benefits: Social Facilitation, Influence on Others, Convenience; Negative Affect Reduction: Stress Reduction, Appetite Reduction, Boredom Reduction; and Negative Consequences: Health Risks, Addiction, Secondhand Effects). CONCLUSIONS/IMPORTANCE Previously identified smoking expectancies appear relevant for young adult vaping, with some notable refinements. Positive reinforcement aspects encompassed aerosol clouds, vaping tricks, and unique flavors. Social benefits included influencing others via social media and competitive activity, as well as the convenience of use in a variety of places. Negative affect reduction was controversial among user groups, but vaping was seen as more interesting than smoking and thus more effective at boredom reduction. Young adults were uncertain regarding negative consequences, but appreciated a potential for secondhand effects. Measure refinement via qualitative research and future field testing can enhance our understanding of this relatively new behavior, supporting tobacco control surveillance, marketing/labeling regulations, and counter-advertising development/evaluation.
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Affiliation(s)
- Paul T Harrell
- Division of Community Health & Research, Department of Pediatrics, Eastern Virginia Medical School, Norfolk, VA, USA
- Department of Psychiatry & Behavioral Sciences, Eastern Virginia Medical School, Norfolk, VA, USA
| | - Thomas H Brandon
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | - Kelli J England
- Division of Community Health & Research, Department of Pediatrics, Eastern Virginia Medical School, Norfolk, VA, USA
- Department of Psychiatry & Behavioral Sciences, Eastern Virginia Medical School, Norfolk, VA, USA
| | - Tracey E Barnett
- School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Laurel O Brockenberry
- Division of Community Health & Research, Department of Pediatrics, Eastern Virginia Medical School, Norfolk, VA, USA
- Department of Psychiatry & Behavioral Sciences, Eastern Virginia Medical School, Norfolk, VA, USA
| | - Vani N Simmons
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | - Gwendolyn P Quinn
- Department of Population Health, New York University, New York, NY, USA
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Chatterjee S, Tao JQ, Johncola A, Guo W, Caporale A, Langham MC, Wehrli FW. Acute exposure to e-cigarettes causes inflammation and pulmonary endothelial oxidative stress in nonsmoking, healthy young subjects. Am J Physiol Lung Cell Mol Physiol 2019; 317:L155-L166. [PMID: 31042077 DOI: 10.1152/ajplung.00110.2019] [Citation(s) in RCA: 76] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
The effects of e-cigarette (e-cig) aerosol inhalation by nonsmokers have not been examined to date. The present study was designed to evaluate the acute response to aerosol inhalation of non-nicotinized e-cigarettes in terms of oxidative stress and indices of endothelial activation in human pulmonary microvascular endothelial cells (HPMVEC). Ten smoking-naïve healthy subjects (mean age ± SD = 28.7 ± 5.5 yr) were subjected to an e-cig challenge, following which their serum was monitored for markers of inflammation [C-reactive protein (CRP) and soluble intercellular adhesion molecule (sICAM)] and nitric oxide metabolites (NOx). The oxidative stress and inflammation burden of the circulating serum on the vascular network was also assessed by measuring reactive oxygen species (ROS) production and induction of ICAM-1 expression on HPMVEC. Our results show that serum indices of oxidative stress and inflammation increased significantly (P < 0.05 as compared with baseline), reaching a peak at approximately 1-2 h post-e-cig aerosol inhalation and returning to baseline levels at 6 h. The circulatory burden of the serum (ICAM-1 and ROS) increased significantly at 2 h and returned to baseline values 6 h post-e-cig challenge. ROS production by HPMVEC was found to occur via activation of the NADPH oxidase 2 (NOX2) pathways. These findings suggest that even in the absence of nicotine, acute e-cig aerosol inhalation leads to a transient increase in oxidative stress and inflammation. This can adversely affect the vascular endothelial network by promoting oxidative stress and immune cell adhesion. Thus e-cig inhalation has the potential to drive the onset of vascular pathologies.
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Affiliation(s)
- Shampa Chatterjee
- Institute for Environmental Medicine and Department of Physiology, University of Pennsylvania Perelman School of Medicine , Philadelphia, Pennsylvania
| | - Jian-Qin Tao
- Institute for Environmental Medicine and Department of Physiology, University of Pennsylvania Perelman School of Medicine , Philadelphia, Pennsylvania
| | - Alyssa Johncola
- Laboratory for Structural, Physiologic and Functional Imaging, Department of Radiology, University of Pennsylvania Health System , Philadelphia, Pennsylvania
| | - Wensheng Guo
- Department of Biostatistics and Epidemiology, University of Pennsylvania Perelman School of Medicine , Philadelphia, Pennsylvania
| | - Alessandra Caporale
- Laboratory for Structural, Physiologic and Functional Imaging, Department of Radiology, University of Pennsylvania Health System , Philadelphia, Pennsylvania
| | - Michael C Langham
- Laboratory for Structural, Physiologic and Functional Imaging, Department of Radiology, University of Pennsylvania Health System , Philadelphia, Pennsylvania
| | - Felix W Wehrli
- Laboratory for Structural, Physiologic and Functional Imaging, Department of Radiology, University of Pennsylvania Health System , Philadelphia, Pennsylvania
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Cioe PA, Gordon REF, Guthrie KM, Freiberg MS, Kahler CW. Perceived barriers to smoking cessation and perceptions of electronic cigarettes among persons living with HIV. AIDS Care 2018; 30:1469-1475. [PMID: 29927614 PMCID: PMC6296254 DOI: 10.1080/09540121.2018.1489103] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Smoking is more prevalent in persons living with HIV than the general population and is linked to increased morbidity and mortality. Some have suggested that based on current knowledge of harms and benefits, it may be feasible to advise smokers who are unable or unwilling to quit to switch to electronic cigarettes (ECs) as a less harmful alternative. We conducted 25 qualitative interviews with HIV-positive current or former smokers to explore perceived barriers to smoking cessation and perceptions of ECs. A high level of nicotine dependence, smoking as a form of stress management, motivational factors (including lack of readiness, low self-efficacy, ambivalence toward quitting), and having a social network of smokers were identified as cessation barriers. Low knowledge of ECs and uncertainty about EC safety and efficacy were barriers to EC uptake. However, current smokers indicated a willingness to try ECs. This study provides evidence that HIV-positive smokers face significant individual and environmental barriers to cessation. ECs may have potential as a harm reduction strategy in this population; however, there is a significant need for education regarding use and relative safety.
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Affiliation(s)
- Patricia A. Cioe
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI
| | - Rebecca E. F. Gordon
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI
| | - Kate M. Guthrie
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI
- Department of Psychiatry & Human Behavior, Alpert Medical School, Brown University, Providence, RI
- Centers for Behavioral & Preventive Medicine, The Miriam Hospital, Providence, RI
| | - Matthew S. Freiberg
- Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN
| | - Christopher W. Kahler
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI
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17
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Goldberg RL, Cataldo JK. Using an e-Cigarette is Like Eating Tofu When You Really Want Meat. Am J Health Behav 2018; 42:54-64. [PMID: 30688641 DOI: 10.5993/ajhb.42.5.5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Objective Whereas controversy about the e-cigarette's effectiveness and safety as a smoking cessation tool continues, e-cigarette use prevalence continues rising. In this study, we sought to describe experiences of adult e-cigarette users and to examine their motivations, beliefs, and use patterns. Methods This qualitative study included one-on-one semi-structured phone interviews with 20 current California e-cigarette users (mean age = 38 ± 9.44 years). Interviews were transcribed and thematically analyzed using MAXQDA. Results E-cigarettes initially addressed participants' problems related to smoking; they no longer smelled like cigarette smoke and could avoid smoke-free regulations. Participants highlighted the importance of e-cigarette flavors and of "receiving moral credit" for harm reduction by using e-cigarettes to quit smoking cigarettes. Many described eventual dissatisfaction with e-cigarettes, which resulted in relapse to cigarette smoking and/or dual use with cigarettes. The convenience of e-cigarettes coupled with the pattern of constant use left participants increasingly reliant on e-cigarettes. Conclusion Ultimately, failed cessation and dual use exposes smokers to greater levels of nicotine, while still exposing them to cigarette smoke. Public health campaigns should promote awareness of the risks of using e-cigarettes, including failed cessation attempts, dual use, addiction, and other health consequences.
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Affiliation(s)
- Rachel L Goldberg
- Clinical Research Coordinator, Department of Physiological Nursing, University of California San Francisco, San Francisco, CA, USA
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18
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Gibson LA, Creamer MR, Breland AB, Giachello AL, Kaufman A, Kong G, Pechacek TF, Pepper JK, Soule EK, Halpern-Felsher B. Measuring perceptions related to e-cigarettes: Important principles and next steps to enhance study validity. Addict Behav 2018; 79:219-225. [PMID: 29175027 DOI: 10.1016/j.addbeh.2017.11.017] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Revised: 09/26/2017] [Accepted: 11/09/2017] [Indexed: 12/28/2022]
Abstract
Measuring perceptions associated with e-cigarette use can provide valuable information to help explain why youth and adults initiate and continue to use e-cigarettes. However, given the complexity of e-cigarette devices and their continuing evolution, measures of perceptions of this product have varied greatly. Our goal, as members of the working group on e-cigarette measurement within the Tobacco Centers of Regulatory Science (TCORS) network, is to provide guidance to researchers developing surveys concerning e-cigarette perceptions. We surveyed the 14 TCORS sites and received and reviewed 371 e-cigarette perception items from seven sites. We categorized the items based on types of perceptions asked, and identified measurement approaches that could enhance data validity and approaches that researchers may consider avoiding. The committee provides suggestions in four areas: (1) perceptions of benefits, (2) harm perceptions, (3) addiction perceptions, and (4) perceptions of social norms. Across these 4 areas, the most appropriate way to assess e-cigarette perceptions depends largely on study aims. The type and number of items used to examine e-cigarette perceptions will also vary depending on respondents' e-cigarette experience (i.e., user vs. non-user), level of experience (e.g., experimental vs. established), type of e-cigarette device (e.g., cig-a-like, mod), and age. Continuous formative work is critical to adequately capture perceptions in response to the rapidly changing e-cigarette landscape. Most important, it is imperative to consider the unique perceptual aspects of e-cigarettes, building on the conventional cigarette literature as appropriate, but not relying on existing conventional cigarette perception items without adjustment.
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Affiliation(s)
| | - MeLisa R Creamer
- University of Texas Health Science Center, Houston School of Public Health, Austin, Regional Campus, TX, USA
| | | | | | - Annette Kaufman
- Tobacco Control Research Branch, Behavioral Research Program, Division of Cancer Control & Population Sciences, National Cancer Institute, Rockville, MD, USA
| | - Grace Kong
- Yale University School of Medicine, New Haven, CT, USA
| | | | - Jessica K Pepper
- University of North Carolina at Chapel Hill, NC, USA; RTI International, Research Triangle Park, NC, USA
| | - Eric K Soule
- Virginia Commonwealth University, Richmond, VA, USA
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19
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Soule EK, Maloney SF, Guy MC, Eissenberg T, Fagan P. User-identified electronic cigarette behavioral strategies and device characteristics for cigarette smoking reduction. Addict Behav 2018; 79:93-101. [PMID: 29272713 DOI: 10.1016/j.addbeh.2017.12.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Revised: 12/01/2017] [Accepted: 12/07/2017] [Indexed: 12/01/2022]
Abstract
BACKGROUND There is limited evidence on how cigarette smokers use electronic cigarettes (ECIGs) for smoking cessation and reduction. This study used concept mapping, a participatory mixed-methods research approach, to identify ECIG use behaviors and device characteristics perceived to be associated with cigarette smoking cessation or reduction. METHODS Current ECIG users aged 18-64 were recruited from seven cities selected randomly from U.S. census tract regions. Participants were invited to complete concept mapping tasks: brainstorming, sorting and rating (n=72). During brainstorming, participants generated statements in response to a focus prompt ("A SPECIFIC WAY I HAVE USED electronic cigarettes to reduce my cigarette smoking or a SPECIFIC WAY electronic cigarettes help me reduce my cigarette smoking is…") and then sorted and rated the statements. Multidimensional scaling and hierarchical cluster analyses were used to generate a cluster map that was interpreted by the research team. RESULTS Eight thematic clusters were identified: Convenience, Perceived Health Effects, Ease of Use, Versatility and Variety, Advantages of ECIGs over Cigarettes, Cigarette Substitutability, Reducing Harms to Self and Others, and Social Benefits. Participants generated several statements that related to specific behavioral strategies used when using ECIGs for smoking reduction/complete switching behaviors such as making rapid transitions from smoking to ECIG use or using certain ECIG liquids or devices. Former smokers rated the Perceived Health Effects cluster and several behavioral strategy statements higher than current smokers. CONCLUSIONS These results help to identify ECIG use behaviors and characteristics perceived by ECIG users to aid in cigarette smoking cessation or reduction.
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Affiliation(s)
- Eric K Soule
- Center for the Study of Tobacco Products, Virginia Commonwealth University, United States; Virginia Commonwealth University, Department of Psychology, PO Box 980205, Richmond, VA 23298, United States.
| | - Sarah F Maloney
- Center for the Study of Tobacco Products, Virginia Commonwealth University, United States; Virginia Commonwealth University, Department of Psychology, PO Box 980205, Richmond, VA 23298, United States.
| | - Mignonne C Guy
- Center for the Study of Tobacco Products, Virginia Commonwealth University, United States; Virginia Commonwealth University, Department of African American Studies, PO Box 842509, Richmond, VA 23284, United States.
| | - Thomas Eissenberg
- Center for the Study of Tobacco Products, Virginia Commonwealth University, United States; Virginia Commonwealth University, Department of Psychology, PO Box 980205, Richmond, VA 23298, United States.
| | - Pebbles Fagan
- Center for the Study of Tobacco Products, Virginia Commonwealth University, United States; University of Arkansas for Medical Sciences, Fay W. Boozman College of Public Health, Department of Health Behavior and Health Education, 4301 West Markham Street #820, Little Rock, AR 72205, United States.
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Russo C, Cibella F, Mondati E, Caponnetto P, Frazzetto E, Caruso M, Caci G, Polosa R. Lack of Substantial Post-Cessation Weight Increase in Electronic Cigarettes Users. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15040581. [PMID: 29570695 PMCID: PMC5923623 DOI: 10.3390/ijerph15040581] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 03/20/2018] [Accepted: 03/21/2018] [Indexed: 02/06/2023]
Abstract
Minimization of post-cessation weight gain in quitters is important, but existing approaches (e.g., antismoking medications) shows only limited success. We investigated changes in body weight in smokers who quit or reduced substantially their cigarette consumption by switching to electronic cigarettes (ECs) use. Body weight and smoking/vaping history were extracted from medical records of smokers and ex-smokers to match three study groups: (1) regular EC users on at least two consecutive follow-up visits; (2) regular smokers (and not using ECs); (3) subjects who reported sustained smoking abstinence after completing a cessation program. Review of their medical records was conducted at two follow-up visits at 6- (F/U 6m) and 12-months (F/U 12m). A total of 86 EC users, 93 regular smokers, and 44 quitters were studied. In the EC users study group, cigarettes/day use decreased from 21.1 at baseline to 1.8 at F/U 12m (p < 0.0001). Dual usage was reported by approximately 50% of EC users. Both within factor (time, p < 0.0001) and between factor (study groups, p < 0.0001) produced significant effect on weight (% change from baseline), with a significant 4.8% weight gain from baseline in the quitters study group at F/U 12m. For the EC users, weight gain at F/U 12m was only 1.5% of baseline. There was no evidence of post-cessation weight increase in those who reduced substantially cigarette consumption by switching to ECs (i.e., dual users) and only modest post-cessation weight increase was reported in exclusive EC users at F/U 12m. By reducing weight gain and tobacco consumption, EC-based interventions may promote an overall improvement in quality of life.
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Affiliation(s)
| | - Fabio Cibella
- National Research Council of Italy, Institute of Biomedicine and Molecular Immunology, 90100 Palermo, Italy.
| | - Enrico Mondati
- Institute of Internal and Emergency Medicine, Azienda Ospedaliero-Universitaria "Policlinico-V. Emanuele", University of Catania, 95123 Catania, Italy.
- Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy.
| | - Pasquale Caponnetto
- Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy.
- Centro per la Prevenzione e Cura del Tabagismo (CPCT), Azienda Ospedaliero-Universitaria "Policlinico-V. Emanuele", University of Catania, 95123 Catania, Italy.
| | - Evelise Frazzetto
- Institute of Internal and Emergency Medicine, Azienda Ospedaliero-Universitaria "Policlinico-V. Emanuele", University of Catania, 95123 Catania, Italy.
- Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy.
| | - Massimo Caruso
- Institute of Internal and Emergency Medicine, Azienda Ospedaliero-Universitaria "Policlinico-V. Emanuele", University of Catania, 95123 Catania, Italy.
- Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy.
| | - Grazia Caci
- Institute of Internal and Emergency Medicine, Azienda Ospedaliero-Universitaria "Policlinico-V. Emanuele", University of Catania, 95123 Catania, Italy.
| | - Riccardo Polosa
- Institute of Internal and Emergency Medicine, Azienda Ospedaliero-Universitaria "Policlinico-V. Emanuele", University of Catania, 95123 Catania, Italy.
- Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy.
- Centro per la Prevenzione e Cura del Tabagismo (CPCT), Azienda Ospedaliero-Universitaria "Policlinico-V. Emanuele", University of Catania, 95123 Catania, Italy.
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Pokhrel P, Lam TH, Pagano I, Kawamoto CT, Herzog TA. Young adult e-cigarette use outcome expectancies: Validity of a revised scale and a short scale. Addict Behav 2018; 78:193-199. [PMID: 29195147 DOI: 10.1016/j.addbeh.2017.11.019] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Revised: 11/03/2017] [Accepted: 11/10/2017] [Indexed: 12/13/2022]
Abstract
The revised youth e-cigarette outcome expectancies measure adds new items informed by recent qualitative research with young adult e-cigarette users, especially in the domain of positive "smoking" experience. Positive "smoking" experience represents beliefs that use of e-cigarettes provides outcomes associated with a better "smoking" alternative: for example, an alternative that is more socially approved, more suitable for indoor use, and that provides a safer means of enjoying nicotine. In addition, we tested a short, 8-item version of the measure which may be more easily incorporated into surveys. We tested the validity of the revised measure, both long and short versions, in terms of factor structure and associations of the expectancy factors with current e-cigarette use, e-cigarette use susceptibility, and e-cigarette use dependence. Participants were young adults (N=470; 65% women; mean age=20.9, SD=2.1). Results replicated the findings of the previous study as well as highlighted the importance of the added domain of positive "smoking" experience and the validity of the short scale. Furthermore, results showed that positive outcome expectancies are strongly associated with e-cigarette use dependence. The long and short versions of the revised youth e-cigarette outcome expectancies scale appear to be valid and useful for application not only among cigarette smokers and e-cigarette users but also among never smokers and never e-cigarette users.
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Affiliation(s)
- Pallav Pokhrel
- Cancer Prevention in the Pacific Program, University of Hawaii Cancer Center, 701 Ilalo St, Honolulu, HI 96813, United States.
| | - Tony H Lam
- Cancer Prevention in the Pacific Program, University of Hawaii Cancer Center, 701 Ilalo St, Honolulu, HI 96813, United States
| | - Ian Pagano
- Cancer Prevention in the Pacific Program, University of Hawaii Cancer Center, 701 Ilalo St, Honolulu, HI 96813, United States
| | - Crissy T Kawamoto
- Cancer Prevention in the Pacific Program, University of Hawaii Cancer Center, 701 Ilalo St, Honolulu, HI 96813, United States
| | - Thaddeus A Herzog
- Cancer Prevention in the Pacific Program, University of Hawaii Cancer Center, 701 Ilalo St, Honolulu, HI 96813, United States
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Health impact of E-cigarettes: a prospective 3.5-year study of regular daily users who have never smoked. Sci Rep 2017; 7:13825. [PMID: 29150612 PMCID: PMC5693960 DOI: 10.1038/s41598-017-14043-2] [Citation(s) in RCA: 94] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Accepted: 10/03/2017] [Indexed: 01/12/2023] Open
Abstract
Although electronic cigarettes (ECs) are a much less harmful alternative to tobacco cigarettes, there is concern as to whether long-term ECs use may cause risks to human health. We report health outcomes (blood pressure, heart rate, body weight, lung function, respiratory symptoms, exhaled breath nitric oxide [eNO], exhaled carbon monoxide [eCO], and high-resolution computed tomography [HRCT] of the lungs) from a prospective 3.5-year observational study of a cohort of nine daily EC users (mean age 29.7 (±6.1) years) who have never smoked and a reference group of twelve never smokers. No significant changes could be detected over the observation period from baseline in the EC users or between EC users and control subjects in any of the health outcomes investigated. Moreover, no pathological findings could be identified on HRCT of the lungs and no respiratory symptoms were consistently reported in the EC user group. Although it cannot be excluded that some harm may occur at later stages, this study did not demonstrate any health concerns associated with long-term use of EC in relatively young users who did not also smoke tobacco.
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