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Gomes MN, Reid JL, Rynard VL, East KA, Goniewicz ML, Piper ME, Hammond D. Comparison of Indicators of Dependence for Vaping and Smoking: Trends Between 2017 and 2022 Among Youth in Canada, England, and the United States. Nicotine Tob Res 2024; 26:1192-1200. [PMID: 38531767 PMCID: PMC11339172 DOI: 10.1093/ntr/ntae060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 03/13/2024] [Accepted: 03/17/2024] [Indexed: 03/28/2024]
Abstract
INTRODUCTION The current study sought to examine trends in indicators of dependence for youth vaping and smoking during a period of rapid evolution in the e-cigarette market. AIMS AND METHODS Data are from repeat cross-sectional online surveys conducted between 2017 and 2022 among youth aged 16-19 in Canada, England, and the United States (US). Participants were 23 145 respondents who vaped and/or smoked in the past 30 days. Four dependence indicators were assessed for smoking and vaping (perceived addiction, frequent strong urges, time to first use after waking, days used in past month) and two for vaping only (use events per day, e-cigarette dependence scale). Regression models examined differences by survey wave and country, adjusting for sex, age, race, and exclusive/dual use. RESULTS All six indicators of dependence increased between 2017 and 2022 among youth who vaped in the past 30 days (p < .001 for all). For example, more youth reported strong urges to vape at least most days in 2022 than in 2017 (Canada: 26.5% to 53.4%; England: 25.5% to 45.4%; US: 31.6% to 50.3%). In 2017, indicators of vaping dependence were substantially lower than for smoking; however, by 2022, youth vaping was associated with a greater number of days used in the past month (Canada, US), shorter time to first use (all countries), and a higher likelihood of frequent strong urges (Canada, US) compared to youth smoking. CONCLUSIONS From 2017 to 2022, indicators of vaping dependence increased substantially. By 2022, vaping dependence indices were comparable to those of smoking. IMPLICATIONS Indicators of vaping dependence among youth have increased substantially since 2017 to levels that are comparable to cigarette dependence among youth who smoke. Future research should examine factors underlying the increase in dependence among youth who vape, including changes to the nicotine profile and design of e-cigarette products.
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Affiliation(s)
- Makenna N Gomes
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Jessica L Reid
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Vicki L Rynard
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Katherine A East
- Department of Addictions, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London, UK
| | - Maciej L Goniewicz
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Megan E Piper
- Center for Tobacco Research and Intervention, School of Medicine and Public Health, University of Wisconsin Madison, Madison, WI, USA
| | - David Hammond
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
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Betts JM, Dowd AN, Motschman CA, Tiffany ST. An Evaluation of the Contextual Factors Associated With the Use of Either Tobacco or Electronic Cigarettes in Individuals Who Dual Use. Nicotine Tob Res 2024; 26:561-570. [PMID: 37831904 DOI: 10.1093/ntr/ntad203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 08/14/2023] [Accepted: 10/08/2023] [Indexed: 10/15/2023]
Abstract
INTRODUCTION Little is known about patterns of dual use of tobacco and electronic cigarettes (e-cigarettes), especially regarding the factors that lead people to choose either product in particular situations. Identifying contextual factors that are associated with product use would enhance understanding of the maintenance of dual product use. METHODS Individuals who dual use (N = 102) completed ecological momentary assessment surveys via text message regarding the recent use of tobacco and e-cigarettes for 2 weeks. Product legality, availability, craving, the presence of other people who smoke/vape, and social disapproval were assessed. Data were analyzed using hierarchical logistic regression to identify factors associated with the likelihood of tobacco versus e-cigarette use. RESULTS Contexts associated with increased likelihood of using tobacco rather than e-cigarettes included being in the presence of other people who smoke (odds ratio [OR] = 3.50, p < .0001) and experiencing elevated tobacco cigarette craving (OR = 3.51, p < .0001). Decreased likelihood of tobacco over e-cigarette use was associated with smoking restrictions (OR = 0.26, p = .003), the presence of other people who vape (OR = 0.38, p < .001), and experiencing elevated e-cigarette craving (OR = 0.23, p < .0001). The legality of e-cigarettes, social disapproval, and the availability of the alternative product were not significantly associated with the use of one product over the other. An individual difference score of relative tobacco (vs. e-cigarette) use pattern did not significantly moderate these effects. CONCLUSIONS This study provided essential information regarding behavioral patterns of dual use, which informs our understanding of people who dual use. Contexts such as smoking restrictions, craving, and social context significantly differentiated between the use of tobacco and e-cigarettes. This suggests product-specific motivations for dual use of tobacco and e-cigarettes in people who use both. IMPLICATIONS This study assessed the relationship between momentary contextual factors and dual use in a nationally recruited sample of people who dual use. Assessments of dual use in daily life provided novel information regarding patterns of dual use as well as differential use-motivations for each product. This information will be essential to build a theoretical framework of dual use of tobacco and e-cigarettes.
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Affiliation(s)
- Jennifer M Betts
- Department of Psychology, University of Buffalo, State University of New York, Buffalo, NY, USA
- Center for Tobacco Research and Intervention, University of Wisconsin Madison School of Medicine and Public Health, Madison, WI, USA
- William S. Middleton Memorial Veterans' Hospital, Madison, WI, USA
| | - Ashley N Dowd
- Department of Psychology, University of Buffalo, State University of New York, Buffalo, NY, USA
- Behavioral Pharmacology Research Unit, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Courtney A Motschman
- Department of Psychology, University of Buffalo, State University of New York, Buffalo, NY, USA
| | - Stephen T Tiffany
- Department of Psychology, University of Buffalo, State University of New York, Buffalo, NY, USA
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Miele C, Cabé J, Cabé N, Bertsch I, Brousse G, Pereira B, Moulin V, Barrault S. Measuring craving: A systematic review and mapping of assessment instruments. What about sexual craving? Addiction 2023; 118:2277-2314. [PMID: 37493019 DOI: 10.1111/add.16287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 05/31/2023] [Indexed: 07/27/2023]
Abstract
BACKGROUND AND AIMS Craving is central in the definition of addictive disorders because of its diagnostic and prognostic value. Its measurement is essential in clinical practice. Previous reviews provided a better overview of existing instruments; however, they do not consider emerging substances and behaviors such as sexual addictions. Our objectives were threefold: (1) to provide a systematic review of craving assessment instruments and their psychometric characteristics within a transdiagnostic approach, (2) to highlight and map their conceptual relationships and (3) to identify potential sexual craving assessment instruments. METHODS The review was conducted using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology. The PubMed, Embase, PsychInfo and Cochrane/Central databases were searched for publications that met the following inclusion criterion: validation studies of craving assessment instruments, regardless of target substance or behavior. The original search identified 4561 references and included 147 articles. Each selected study was a peer-reviewed publication. RESULTS This review provides a synthesis of the psychometric properties of 36 original instruments and identified 93 variations of these instruments (e.g. translations). We were able to highlight five transdiagnostic families of instruments, each corresponding to a conceptual model. Only one instrument for assessing craving in the domain of compulsive sexual behavior, focused on pornography use, has been identified: the Pornography Craving Questionnaire. CONCLUSION This review mapped all craving assessment instruments from a transdiagnostic perspective, finding 36 original instruments and 93 variations. The evolution of instruments to measure craving mirrors the evolution of the concept of craving which has progressively integrated cognitive, conditioning and sensory dimensions, and attests to the importance of the context of assessment. Development of an instrument to measure 'sexual craving' is needed and could be based on the data from our review.
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Affiliation(s)
- Cécile Miele
- Laboratory QualiPsy, EE1901, Psychology Department, University of Tours, Tours, France
- Service d'Addictologie et de pathologies duelles, Pôle de psychiatrie, CHU de Clermont-Ferrand, Clermont-Ferrand Cedex, France
- Laboratoire Inter-universitaire de Psychologie Personnalité, Cognition, Changement Social (LIP/PC2S) Université de Grenoble Alpes, Grenoble, France
| | - Julien Cabé
- Service d'Addictologie et de pathologies duelles, Pôle de psychiatrie, CHU de Clermont-Ferrand, Clermont-Ferrand Cedex, France
- Université Clermont Auvergne, Clermont Auvergne INP, CHU Clermont-Ferrand, CNRS, Institut Pascal, Clermont-Ferrand, France
| | - Nicolas Cabé
- Service d'Addictologie, Centre Hospitalier Universitaire de Caen, Caen, France
- Normandie Université, UNICAEN, INSERM, PhIND 'Physiopathology and Imaging of Neurological Disorders', Institut Blood and Brain at Caen-Normandie, Cyceron, Caen, France
| | - Ingrid Bertsch
- Laboratory QualiPsy, EE1901, Psychology Department, University of Tours, Tours, France
- Unité de Consultation Psychiatrique Post-Pénale (UC3P), CHRU de Tours, Tours, France
| | - Georges Brousse
- Service d'Addictologie et de pathologies duelles, Pôle de psychiatrie, CHU de Clermont-Ferrand, Clermont-Ferrand Cedex, France
- Université Clermont Auvergne, Clermont Auvergne INP, CHU Clermont-Ferrand, CNRS, Institut Pascal, Clermont-Ferrand, France
| | - Bruno Pereira
- Direction de la Recherche Clinique et de l'Innovation, CHU de Clermont-Ferrand, Clermont-Ferrand, France
| | - Valérie Moulin
- Laboratoire Inter-universitaire de Psychologie Personnalité, Cognition, Changement Social (LIP/PC2S) Université de Grenoble Alpes, Grenoble, France
| | - Servane Barrault
- Laboratory QualiPsy, EE1901, Psychology Department, University of Tours, Tours, France
- Centre de Soins d'Accompagnement et de Prévention en Addictologie (CSAPA 37), CHRU of Tours, Tours, France
- Laboratory of Psychopathology and Health Processes, University of Paris, Boulogne-Billancourt, France
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Lohner V, McNeill A, Schneider S, Vollstädt-Klein S, Andreas M, Szafran D, Grundinger N, Demjén T, Fernandez E, Przewozniak K, Tountas Y, Trofor A, Zatonski W, Willemsen MC, Vardavas C, Fong GT, Mons U. Understanding perceived addiction to and addictiveness of electronic cigarettes among electronic cigarette users: a cross-sectional analysis of the International Tobacco Control Smoking and Vaping (ITC 4CV) England Survey. Addiction 2023; 118:1359-1369. [PMID: 36772958 PMCID: PMC10357132 DOI: 10.1111/add.16162] [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: 08/11/2022] [Accepted: 01/25/2023] [Indexed: 02/12/2023]
Abstract
BACKGROUND AND AIMS The addictive potential of electronic cigarettes (e-cigarettes) remains to be fully understood. We identified patterns and correlates of perceived addiction to e-cigarettes and perceived addictiveness of e-cigarettes relative to tobacco cigarettes (relative addictiveness) in dual users as well as exclusive e-cigarette users. DESIGN, SETTING AND PARTICIPANTS Observational study using cross-sectional survey data from England (2016) from the International Tobacco Control Project (ITC) Four Country Smoking and Vaping (4CV) survey. The study comprised 832 current e-cigarette users who had been vaping for at least 4 months. MEASUREMENTS Perceived addiction to e-cigarettes and relative addictiveness of e-cigarettes were examined. Socio-demographic factors were age, gender and education; markers of addiction included urge to vape, time to first vape after waking and nicotine strength used; vaping and smoking characteristics included frequency and duration of e-cigarette use, intention to quit, adjustable power or temperature, enjoyment, satisfaction relative to tobacco cigarettes and tobacco cigarette smoking status. FINDINGS A total of 17% of participants reported feeling very addicted to e-cigarettes, while 40% considered e-cigarettes equally/more addictive than tobacco cigarettes. Those who felt very addicted had higher odds of regarding e-cigarettes as more addictive than tobacco cigarettes (odds ratio 3.4, 95% confidence interval 2.3-5.1). All markers of addiction, daily use and enjoyment were associated with higher perceived addiction, whereas time to first vape after waking, daily vaping and perceiving vaping as less satisfying than smoking were associated with relative addictiveness. CONCLUSIONS Markers of addiction to e-cigarettes appear to correspond with perceived addiction to e-cigarettes, suggesting that self-reported perceived addiction might serve as an indicator of addiction. Prevalence both of markers of addiction and perceived addiction were comparatively low overall, suggesting a limited but relevant addictive potential of e-cigarettes. Additionally, positive and negative reinforcement, reflected here by enjoyment and relative satisfaction, might play a role in e-cigarette addiction.
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Affiliation(s)
- Valerie Lohner
- Cardiovascular Epidemiology of Aging, Department of Cardiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany
| | - Ann McNeill
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- Shaping public health policies to reduce inequalities & harm (SPECTRUM), UK
| | - Sven Schneider
- Center for Preventive Medicine and Digital Health Baden-Württemberg, Medical Faculty Mannheim, Heidelberg University, Germany
| | - Sabine Vollstädt-Klein
- Department of Addictive Behaviour and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Mannheim Center for Translational Neurosciences (MCTN), Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Marike Andreas
- Center for Preventive Medicine and Digital Health Baden-Württemberg, Medical Faculty Mannheim, Heidelberg University, Germany
| | - Daria Szafran
- Center for Preventive Medicine and Digital Health Baden-Württemberg, Medical Faculty Mannheim, Heidelberg University, Germany
| | - Nadja Grundinger
- Department of Addictive Behaviour and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Tibor Demjén
- Smoking or Health Hungarian Foundation, Budapest, Hungary
| | - Esteve Fernandez
- Tobacco Control Unit and WHO Collaborating Center for Tobacco Control, Catalan Institute of Oncology (ICO), L'Hospitalet de Llobregat, Spain
- Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Spain
- School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
- Consortium for Biomedical Research in Respiratory Diseases (CIBERES), Madrid, Spain
| | - Krzysztof Przewozniak
- Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
- Collegium Civitas, Warsaw, Poland
- Health Promotion Foundation, Warsaw, Poland
| | - Yannis Tountas
- Center for Health Services Research, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Antigona Trofor
- University of Medicine and Pharmacy "Grigore T. Popa" Iasi, Iasi, Romania
- Aer Pur Romania, Bucharest, Romania
| | - Witold Zatonski
- Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
- European Observatory of Health Inequalities, President Stanisław Wojciechowski State University of Applied Sciences, Kalisz, Poland
| | - Marc C. Willemsen
- Maastricht University, Department of Health Promotion (CAPHRI), Maastricht, The Netherlands
- Trimbos Institute, Netherlands Expertise Centre for Tobacco Control, Utrecht, The Netherlands
| | - Constantine Vardavas
- School of Medicine, University of Crete, Crete, Greece
- Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Geoffrey T. Fong
- Department of Psychology, University of Waterloo, Waterloo, ON
- School of Public Health Sciences, University of Waterloo, Waterloo, ON
- Ontario Institute for Cancer Research, Toronto, ON
| | - Ute Mons
- Cardiovascular Epidemiology of Aging, Department of Cardiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany
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Worthen M, Ahmad I. Participatory research on the prevalence of Multi-Substance vaping in college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:782-789. [PMID: 34398697 DOI: 10.1080/07448481.2021.1908303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
OBJECTIVES To assess electronic nicotine delivery system (ENDS) use and vaping behaviors and attitudes in college students. METHODS A student-faculty partnership administered a cross-sectional survey to undergraduate students (N = 339) in 2019. RESULTS 49.8% of students reported using ENDS or vaping in the past 30 days. 48.9% of students who vaped reported vaping more than one substance in the past 30 days. The most commonly vaped substances were cannabis (34.9%), nicotine (26.7%), and flavor (19.2%). Reasons for initiating ENDS use were social (64.8%), for the high (40.8%), and for the flavor (32.4%). Both users and non-users believed ENDS were harmful and favored regulation. CONCLUSIONS Young people who use ENDS commonly vape more than one substance; a critical finding in light of the current vaping lung injury epidemic. The importance of social reasons for initiating ENDS and broad support for regulation suggest jurisdictions consider regulation to reduce ENDS use in young adults.
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Affiliation(s)
- Miranda Worthen
- Department of Public Health and Recreation, San José State University, San Jose, CA, USA
| | - Isra Ahmad
- Santa Clara County Public Health Department, Tobacco-Free Communities, San Jose, CA, USA
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Schuster RM, Cather C, Pachas GN, Nielsen L, Iroegbulem V, Dufour J, Potter K, Levy S, Gray KM, Evins AE. A randomized controlled trial of varenicline and brief behavioral counseling delivered by lay counselors for adolescent vaping cessation: Study protocol. Front Psychiatry 2023; 14:1083791. [PMID: 37009114 PMCID: PMC10050714 DOI: 10.3389/fpsyt.2023.1083791] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 02/22/2023] [Indexed: 03/17/2023] Open
Abstract
BackgroundApproximately one-fifth of high-school seniors and college students currently vape nicotine. Adolescents express a desire to quit vaping, and case reports have shown promise for e-cigarette tapering with dual behavioral and pharmacologic therapies. However, there are no published clinical trials to date that test these intervention approaches for adolescent nicotine vaping cessation. In this three-arm randomized, placebo-controlled, parallel-group study, we aim to assess the efficacy of varenicline in combination with brief behavioral counseling and texting support on vaping cessation in adolescents dependent on vaped nicotine.MethodsThe study will enroll 300 individuals between the ages of 16–25 with daily or near-daily nicotine vaping who reside in the Greater Boston area. Participants will be randomly assigned in a 1:1:1 ratio in blocks of six to one of the three arms: (1) a 12-week course of varenicline titrated to 1 mg bid, brief behavioral counseling delivered by a lay counselor, and an introduction to This is Quitting (TIQ) texting support created by the Truth Initiative; (2) a 12-week course of placebo, brief behavioral counseling, and TIQ; and (3) 12 weeks of enhanced usual care, consisting of advice to quit and an introduction to TIQ. The primary outcome will be biochemically verified continuous vaping abstinence at the end of the treatment (week 12). Secondary outcomes include continuous abstinence at follow-up (week 24), 7-day point prevalence abstinence at weeks 12 and 24, safety and tolerability of varenicline in an adolescent vaping population, as well as change in mood and nicotine withdrawal symptoms across the intervention period. Exploratory outcomes include change in comorbid substance use behaviors and nicotine dependence. Analysis will be intent-to-treat, with multiple imputation sensitivity analyses for participants with missing or incomplete outcome data.DiscussionThis is the first study to evaluate varenicline in combination with a novel, brief, lay counselor delivered vaping cessation program for adolescents who vape nicotine. Results will inform clinicians on the effectiveness and acceptability of this promising, but not yet tested intervention.Clinical trial registration: ClinicalTrials.gov, identifier NCT05367492.
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Affiliation(s)
- Randi M. Schuster
- Department of Psychiatry, Center of Addiction Medicine, Massachusetts General Hospital, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
- *Correspondence: Randi M. Schuster,
| | - Corinne Cather
- Department of Psychiatry, Center of Addiction Medicine, Massachusetts General Hospital, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
| | - Gladys N. Pachas
- Department of Psychiatry, Center of Addiction Medicine, Massachusetts General Hospital, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
| | - Lindsay Nielsen
- Department of Psychiatry, Center of Addiction Medicine, Massachusetts General Hospital, Boston, MA, United States
| | - Vanessa Iroegbulem
- Department of Psychiatry, Center of Addiction Medicine, Massachusetts General Hospital, Boston, MA, United States
| | - Jason Dufour
- Department of Psychiatry, Center of Addiction Medicine, Massachusetts General Hospital, Boston, MA, United States
| | - Kevin Potter
- Department of Psychiatry, Center of Addiction Medicine, Massachusetts General Hospital, Boston, MA, United States
| | - Sharon Levy
- Harvard Medical School, Boston, MA, United States
- Adolescent Substance Use and Addiction Program, Boston Children's Hospital, Boston, MA, United States
| | - Kevin M. Gray
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States
| | - A. Eden Evins
- Department of Psychiatry, Center of Addiction Medicine, Massachusetts General Hospital, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
- A. Eden Evins,
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Clausen B, Rinck M, Nizio P, Matoska CT, Zappi C, Smits JAJ, Gallagher MW, Zvolensky MJ, Garey L. Study protocol for approach bias retraining for nicotine addiction among dual combustible and electronic cigarette users. Contemp Clin Trials 2023; 128:107145. [PMID: 36905980 DOI: 10.1016/j.cct.2023.107145] [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: 11/10/2022] [Revised: 03/05/2023] [Accepted: 03/06/2023] [Indexed: 03/13/2023]
Abstract
BACKGROUND Electronic cigarette (ECIG) use has become a popular method for nicotine delivery. Combustible cigarette (CC) cessation or reduction are the primary reasons for ECIG uptake among adults. Yet, most CC smokers who initiate ECIG use do not fully transition from CC to ECIG, despite intending to quit CC completely. Retraining approach bias, or the approach action tendency toward stimuli related to the substance of interest, has been effective in alcohol and CC use treatments. However, approach bias retraining for both CC and (ECIG) users has not been explored. Therefore, the objective of the study is to evaluate the initial efficacy of approach bias retraining among dual CC and ECIG users. METHODS Eligible dual CC/ECIG using adults (N = 90) will complete a phone-screener, baseline assessment, 4 treatment sessions over 2 weeks, ecological momentary assessments (EMAs) post-intervention, and follow-ups at 4- and 6-week post-intervention. Participants will be assigned to one of three conditions at baseline: (1) CC + ECIG retraining; (2) CC only retraining; and (3) sham retraining. Participants will engage in a self-guided quit attempt to abstain from all nicotine products starting at treatment session 4. CONCLUSIONS The study may lead to a more effective treatment for at-risk nicotine users while simultaneously isolating explanatory mechanisms. The findings should guide advances in the theoretical conceptualization of nicotine addiction for dual users and mechanisms involved in maintaining and abstaining from CC and ECIG, and provide initial effect size data for a brief intervention, thus providing necessary data for a large-scale follow-up trial. Clinical Trials ID: NCT05306158.
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Affiliation(s)
- Bryce Clausen
- Department of Psychology, University of Houston, Houston, TX, United States of America
| | - Mike Rinck
- Behavioral Science Institute, Radboud University, Nijmegen, the Netherlands
| | - Pamella Nizio
- Department of Psychology, University of Houston, Houston, TX, United States of America; HEALTH Institute, University of Houston, Houston, TX, United States of America
| | - Cameron T Matoska
- Department of Psychology, University of Houston, Houston, TX, United States of America
| | - Christopher Zappi
- Department of Psychology, University of Houston, Houston, TX, United States of America
| | - Jasper A J Smits
- Department of Psychology, University of Texas at Austin, Austin, TX, United States of America
| | - Matthew W Gallagher
- Department of Psychology, University of Houston, Houston, TX, United States of America
| | - Michael J Zvolensky
- Department of Psychology, University of Houston, Houston, TX, United States of America; HEALTH Institute, University of Houston, Houston, TX, United States of America; Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, United States of America
| | - Lorra Garey
- Department of Psychology, University of Houston, Houston, TX, United States of America.
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Mavragani A, Görig T, Vollstädt-Klein S, Grundinger N, Mons U, Lohner V, Schneider S, Andreas M. Addictive Potential of e-Cigarettes as Reported in e-Cigarette Online Forums: Netnographic Analysis of Subjective Experiences. J Med Internet Res 2023; 25:e41669. [PMID: 36607713 PMCID: PMC9862333 DOI: 10.2196/41669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 11/03/2022] [Accepted: 11/08/2022] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND While e-cigarettes usually contain nicotine, their addictive potential is not yet fully understood. We hypothesized that if e-cigarettes are addictive, users will experience typical symptoms of addiction. OBJECTIVE The aim of our study was to investigate whether and how e-cigarette users report signs of addiction. METHODS We identified 3 large German-language e-cigarette online forums via a systematic Google search. Based on a netnographic approach, we used deductive content analysis to investigate relevant posts in these forums. Netnography has the advantage of limiting the social desirability bias that prevails in face-to-face research, such as focus groups. The data were coded according to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) criteria for tobacco use disorder, adapted for e-cigarettes. The DSM-5 criteria were used to portray a broad spectrum of possible experiences of addiction. RESULTS Overall, 5337 threads in 3 forums were screened, and 451 threads containing relevant information were included in the analysis. Users reported experiences consistent with the DSM-5 criteria, such as craving e-cigarettes, excessive time spent vaping, and health issues related to e-cigarette use. However, our analysis also showed that users reported the absence of typical tobacco use disorder criteria, such as successful attempts to reduce the nicotine dosage. For most themes, reports of their absence were more frequent than of their presence. The absence of perceived addiction was mostly reported in contrast to prior tobacco smoking. CONCLUSIONS This is the first study to use a netnographic approach to explore unfiltered self-reports of experiences of e-cigarette addiction by users in online forums. As hypothesized, some but not all users reported subjective experiences that corresponded to the criteria of tobacco use disorder as defined by the DSM-5. Nevertheless, subjective reports also indicated that many e-cigarette users felt in control of their behavior, especially in contrast to their prior use of tobacco cigarettes. The finding that some e-cigarette users subjectively experience addiction highlights the need for effective cessation programs to support users who experience their e-cigarette use as burdensome. This research can guide the refinement of instruments to assess e-cigarette addiction and guide cessation programs. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1186/s40359-021-00682-8.
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Affiliation(s)
| | - Tatiana Görig
- Department of Medical Informatics, Biometry and Epidemiology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Sabine Vollstädt-Klein
- Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty of Mannheim, University of Heidelberg, Mannheim, Germany.,Mannheim Center for Translational Neurosciences, Medical Faculty of Mannheim, University of Heidelberg, Mannheim, Germany
| | - Nadja Grundinger
- Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty of Mannheim, University of Heidelberg, Mannheim, Germany
| | - Ute Mons
- Cardiovascular Epidemiology of Aging, Department of Cardiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Valerie Lohner
- Cardiovascular Epidemiology of Aging, Department of Cardiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Sven Schneider
- Division of Public Health, Social and Preventive Medicine, Center for Preventive Medicine and Digital Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Marike Andreas
- Division of Public Health, Social and Preventive Medicine, Center for Preventive Medicine and Digital Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
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Ng G, Attwells S, Zawertailo L. The development and validation of an electronic nicotine delivery system (ENDS) image cue stimulus set. Drug Alcohol Depend 2022; 236:109496. [PMID: 35605534 DOI: 10.1016/j.drugalcdep.2022.109496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 05/07/2022] [Accepted: 05/10/2022] [Indexed: 11/18/2022]
Abstract
RATIONALE Responsiveness to drug-related cues assesses drug reward in research studies. There are currently no validated visual image cues related to electronic nicotine delivery systems (ENDS), thus, this study aimed to develop and validate affective ENDS image cues. METHODS ENDS users and non-vaping individuals in the United States and Canada were recruited via Amazon MTurk. A total of 120 ENDS-related images and 56 neutral images, matched for visual similarity, were assessed. These images were either selected from public databases or were photographed by study staff. Closely adhering to the International Affective Picture System procedure, each participant rated 66 images one-by-one on dimensions of valence, arousal, dominance, and desire-to-vape where higher scores indicated greater feelings of happiness, excitement, loss of control, and desire to vape. RESULTS After excluding patterned responses, the data from 926 participants (610 ENDS users, and 316 non-vaping controls) were analyzed. When viewing ENDS-related images, desire-to-vape scores were correlated with valence (r = 0.55, p < 0.0005), arousal (r = 0.72, p < 0.0005), and dominance (r = 0.58, p < 0.0005) scores. Images that elicited greater desires to vape also elicited greater feelings of happiness and excitement, but less perceived control. Correlations between arousal and valence (r = 0.42, p < 0.0005) and dominance (r = 0.71, p < 0.0005) suggest that images that increased feelings of excitement also increased happiness and decreased perceived control. CONCLUSIONS Correlational findings of the affective ENDS-related images were similar to those of previous studies validating collections of tobacco and alcohol picture cues, supporting the future use of these stimuli in ENDS research.
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Affiliation(s)
- Ginnie Ng
- Department of Pharmacology and Toxicology, University of Toronto, 1 King's College Circle, Toronto, Ontario M5S 1A8, Canada; Centre for Addiction and Mental Health, 1025 Queen Street West, Toronto, Ontario M6J 1H4, Canada
| | - Sophia Attwells
- Centre for Addiction and Mental Health, 1025 Queen Street West, Toronto, Ontario M6J 1H4, Canada
| | - Laurie Zawertailo
- Department of Pharmacology and Toxicology, University of Toronto, 1 King's College Circle, Toronto, Ontario M5S 1A8, Canada; Centre for Addiction and Mental Health, 1025 Queen Street West, Toronto, Ontario M6J 1H4, Canada.
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10
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Park E, Kwon M, Chacko T, Zhou Y, Chen C, Goniewicz ML, Li CS, Chang YP. Instruments to measure e-cigarette related constructs: a systematic review. BMC Public Health 2022; 22:1135. [PMID: 35668485 PMCID: PMC9172158 DOI: 10.1186/s12889-022-13510-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 05/10/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Electronic cigarettes (e-cigarettes) are relatively new tobacco products that are attracting public attention due to their unique features, especially their many flavor options and their potential as an alternative to cigarettes. However, uncertainties remain regarding the determinants and consequences of e-cigarette use because current research on e-cigarettes is made more difficult due to the lack of psychometrically sound instruments that measure e-cigarette related constructs. This systematic review therefore seeks to identify the instruments in the field that are designed to assess various aspects of e-cigarette use or its related constructs and analyze the evidence presented regarding the psychometric properties of the identified instruments. METHODS This systematic review utilized six search engines: PubMed, Medline, CINAHL, PsycINFO, Web of Science, and EMBASE, to identify articles published in the peer-reviewed journals from inception to February 2022 that contained development or validation processes for these instruments. RESULTS Eighteen articles describing the development or validation of 22 unique instruments were identified. Beliefs, perceptions, motives, e-cigarette use, and dependence, were the most commonly assessed e-cigarette related constructs. The included studies reported either construct or criterion validity, with 14 studies reporting both. Most studies did not report the content validity; for reliability, most reported internal consistencies using Cronbach's alpha, with 15 instruments reporting Cronbach's alpha > 0.70 for the scale or its subscales. CONCLUSIONS Twenty-two instruments with a reported development or validation process to measure e-cigarette related constructs are currently available for practitioners and researchers. This review provides a guide for practitioners and researchers seeking to identify the most appropriate existing instruments on e-cigarette use based on the constructs examined, target population, psychometric properties, and instrument length. The gaps identified in the existing e-cigarette related instruments indicate that future studies should seek to extend the validity of the instruments for diverse populations, including adolescents. Instruments that explore additional aspects of e-cigarette use and e-cigarette related constructs to help build a strong theoretical background and expand our current understanding of e-cigarette use and its related constructs, should also be developed.
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Affiliation(s)
- Eunhee Park
- University at Buffalo, School of Nursing, 3435 Main St. University at Buffalo, Wende Hall, Buffalo, NY, 14214-8013, USA.
| | - Misol Kwon
- University at Buffalo, School of Nursing, 3435 Main St. University at Buffalo, Wende Hall, Buffalo, NY, 14214-8013, USA
| | - Thomas Chacko
- University at Buffalo, School of Nursing, 3435 Main St. University at Buffalo, Wende Hall, Buffalo, NY, 14214-8013, USA
| | - Yanjun Zhou
- University at Buffalo, School of Nursing, 3435 Main St. University at Buffalo, Wende Hall, Buffalo, NY, 14214-8013, USA
| | - Chiahui Chen
- University at Buffalo, School of Nursing, 3435 Main St. University at Buffalo, Wende Hall, Buffalo, NY, 14214-8013, USA
| | - Maciej L Goniewicz
- Roswell Park Comprehensive Cancer Center, Elm and Carlton Streets, Buffalo, NY, 14263, USA
| | - Chin-Shang Li
- University at Buffalo, School of Nursing, 3435 Main St. University at Buffalo, Wende Hall, Buffalo, NY, 14214-8013, USA
| | - Yu-Ping Chang
- University at Buffalo, School of Nursing, 3435 Main St. University at Buffalo, Wende Hall, Buffalo, NY, 14214-8013, USA
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11
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Fitzpatrick CL, Kim HS, Sears CR, McGrath DS. Attentional Bias in Non-Smoking Electronic Cigarette Users: An Eye-Tracking Study. Nicotine Tob Res 2022; 24:1439-1447. [PMID: 35443034 DOI: 10.1093/ntr/ntac112] [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: 08/08/2021] [Revised: 02/09/2022] [Accepted: 04/19/2022] [Indexed: 11/13/2022]
Abstract
INTRODUCTION This study examined attentional bias (AB) to e-cigarette cues among a sample of non-smoking daily e-cigarette users (n = 27), non-smoking occasional e-cigarette users (n = 32), and control participants (n = 61) who did not smoke or use e-cigarettes. The possibility that e-cigarette users develop a transference of cues to traditional cigarettes was also examined. METHODS AB was assessed using a free-viewing eye-gaze tracking methodology, in which participants viewed 180 pairs of images for 4 seconds (e-cigarette and neutral image, e-cigarette and smoking image, smoking and neutral image). RESULTS Daily and occasional e-cigarette users attended to pairs of e-cigarette and neutral images equally, whereas non-users attended to neutral images significantly more than e-cigarette images. All three groups attended to e-cigarette images significantly more than smoking images, with significantly larger biases for e-cigarette users. There were no between-group differences in attention to pairs of smoking and neutral images. A moderation analysis indicated that for occasional users but not daily users, years of vaping reduced the bias toward neutral images over smoking images. CONCLUSIONS Taken together, the results indicate that e-cigarette users exhibit heighted attention to e-cigarettes relative to non-users, which may have implications as to how they react to e-cigarette cues in real-world settings. AB for e-cigarettes did not transfer to traditional cigarette cues, which indicates that further research is required to identify the mechanisms involved in the migration of e-cigarettes to traditional cigarettes. IMPLICATIONS This study is the first attempt to examine attentional biases for e-cigarette cues among non-smoking current e-cigarette users using eye-gaze tracking. The results contribute to the growing literature on the correlates of problematic e-cigarette use and indicate that daily and occasional e-cigarette use is associated with attentional biases for e-cigarettes. The existence of attentional biases in e-cigarette users may help to explain the high rate of failure to quit e-cigarettes and provides support for the utility of attentional bias modification in the treatment of problematic e-cigarette use.
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Affiliation(s)
| | - Hyoun S Kim
- Ryerson University, Toronto, Ontario, Canada
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12
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Study protocol: evaluation of the addictive potential of e-cigarettes (EVAPE): neurobiological, sociological, and epidemiological perspectives. BMC Psychol 2021; 9:181. [PMID: 34794514 PMCID: PMC8600891 DOI: 10.1186/s40359-021-00682-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 11/05/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Tobacco use is the largest preventable cause of diseases and deaths; reducing tobacco intake is, therefore, an urgent public health goal. In recent years, e-cigarettes have been marketed as a 'healthier' alternative to tobacco smoking, whilst product features have evolved tremendously in the meantime. A lively scientific debate has developed regarding the potential benefits and risks of e-cigarettes although, surprisingly, there are few studies investigating the addictive potential of nicotine-containing e-cigarettes. The present work comprises three work packages investigating the addictive potential of e-cigarettes from different perspectives: (1) the neurobiological addictive potential of e-cigarettes; (2) the experience and perception of dependence symptoms among users of e-cigarettes in a social context; and (3) the epidemiological perspective regarding factors influencing the potential for dependence. METHODS Work package I: the neurobiological study will investigate the key elements of addiction in e-cigarettes compared to tobacco cigarettes using neurobiological and neuropsychological correlates associated with craving, incentive motivation, cue reactivity and attentional bias. Work package II: the sociological study part examines self-reports on the experience and perception of dependence symptoms in a social context, using focus group interviews and the analysis of posts in online discussion forums on e-cigarettes. Work package III: the epidemiological study part focuses on tolerance development and the role of psychosocial and product factors by analyzing longitudinal data from the International Tobacco Control Policy Evaluation Project (ITC). DISCUSSION The present study offers a chosen mix of three methodological approaches, thereby comprehensively examining core symptoms of positive and negative reinforcement in addiction. Whether e-cigarettes are as reinforcing and addictive as combustible tobacco cigarettes is an important public health issue with implications for prevention and treatment programs. TRIAL REGISTRATION Work package I: Registered at clinicaltrials.gov/ct2/show/NCT04772014. Work package II: Registered at OSF Registries: https://osf.io/dxgya (2021, January 14).
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13
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Rosen RL, Steinberg ML. Factors associated with past-year attempts to quit e-cigarettes among current users: Findings from the Population Assessment of Tobacco and Health Wave 4 (2017-2018). Drug Alcohol Depend 2021; 227:108973. [PMID: 34482034 PMCID: PMC8527564 DOI: 10.1016/j.drugalcdep.2021.108973] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 08/04/2021] [Accepted: 08/07/2021] [Indexed: 11/27/2022]
Abstract
Over 10 million adults report use of electronic nicotine delivery systems (ENDS), with approximately 3.6 million reporting daily use. Even as the popularity of ENDS has increased, both as an available nicotine delivery system and an alternative to combustible cigarette smoking, few studies to date have examined ENDS cessation interest and related behaviors among ENDS users. The current study aimed to describe past year attempts to quit ENDS among current users and to investigate ENDS use / user characteristics associated with unsuccessful attempts to quit in the past year among adult, current, established ENDS users using data from the Population Assessment of Tobacco and Health (PATH) Study Wave 4. Over 10 % of ENDS users reported an attempt to quit completely in the past year, and 60 % indicated future intention to quit completely. Higher nicotine dependence, lower-frequency ENDS use, and higher interest in quitting were associated with past year attempts to quit ENDS. The current study adds support to claims that many ENDS users plan to quit using ENDS someday and highlights the need for continued research on ENDS cessation.
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Affiliation(s)
- Rachel L Rosen
- Rutgers, The State University of New Jersey, Department of Psychology, 152 Frelinghuysen Road, Piscataway, NJ, 08854, USA.
| | - Marc L Steinberg
- Rutgers Robert Wood Johnson Medical School, Department of Psychiatry, 317 George Street, Suite 105, New Brunswick, NJ, 08901, USA
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14
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Manning K, Mayorga NA, Garey L, Kauffman BY, Buckner JD, Zvolensky MJ. The Role of Anxiety Sensitivity and Fatigue Severity in Predicting E-Cigarette Dependence, Barriers to Cessation, and Cravings among Young Adults. Subst Use Misuse 2021; 56:2059-2065. [PMID: 34433376 PMCID: PMC8875305 DOI: 10.1080/10826084.2021.1967990] [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: 10/20/2022]
Abstract
Background: Electronic cigarette (e-cigarette) use has risen dramatically in the United States among young adults; however, little is understood about potential factors that are related to e-cigarette use and maintenance among this population. Fatigue severity is one promising individual difference factor, as past work indicates that it is related to greater withdrawal symptoms and greater dependence on e-cigarettes, and more barriers to quitting. In addition, anxiety sensitivity and severe fatigue are both uniquely related to poor e-cigarette use outcomes; yet, no known studies have examined whether these individual difference factors are related to e-cigarette outcomes among young adults. Method: The current study sought to examine the unique and interactive effects of anxiety sensitivity and fatigue severity in predicting a variety of e-cigarette outcomes among 685 (69.1% female; Mage = 19.61 years, SD = 1.44) young adult e-cigarette users. Results: Results indicated that anxiety sensitivity was significantly associated with greater barriers for cessation (β = .63, p <.001) and e-cigarette cravings (β = .67, p =.001), but not dependence. Fatigue severity was significantly associated with greater e-cigarette dependence (β = .58, p <.001), barriers to cessation (β = 1.56, p <.001), and e-cigarette cravings (β = 3.34, p <.001). The interactive effects of anxiety sensitivity and fatigue severity did not significantly predict the outcomes. Discussion: Results suggest that anxiety sensitivity and fatigue severity independently predict greater e-cigarette maintenance factors among young adults. The current investigation highlights the importance of targeting anxiety sensitivity and fatigue severity among young adult e-cigarette users.
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Affiliation(s)
- Kara Manning
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Nubia A. Mayorga
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Lorra Garey
- Department of Psychology, University of Houston, Houston, TX, USA
| | | | - Julia D. Buckner
- Department of Psychology, Louisiana State University, Baton Rouge, LA, USA
| | - Michael J. Zvolensky
- Department of Psychology, University of Houston, Houston, TX, USA
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- HEALTH Institute, University of Houston, Houston, TX, USA
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15
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Buu A, Cai Z, Li R, Wong SW, Lin HC, Su WC, Jorenby DE, Piper ME. Validating E-Cigarette Dependence Scales Based on Dynamic Patterns of Vaping Behaviors. Nicotine Tob Res 2021; 23:1484-1489. [PMID: 33758949 DOI: 10.1093/ntr/ntab050] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 03/22/2021] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Existing e-cigarette dependence scales are mainly validated based on retrospective overall consumption or perception. Further, given that the majority of adult e-cigarette users also use combustible cigarettes, it is important to determine whether e-cigarette dependence scales capture the product-specific dependence. This study fills in the current knowledge gaps by validating e-cigarette dependence scales using novel indices of dynamic patterns of e-cigarette use behaviors and examining the association between dynamic patterns of smoking and e-cigarette dependence among dual users. METHODS Secondary analysis was conducted on the 2-week ecological momentary assessment data from 116 dual users. The Smoothly Clipped Absolute Deviation penalty (SCAD) was adopted to select important indices for dynamic patterns of consumption or craving and estimate their associations with e-cigarette dependence scales. RESULTS The fitted linear regression models support the hypothesis that higher e-cigarette dependence is associated with higher levels of e-cigarette consumption and craving as well as lower instability of e-cigarette consumption. Controlling for dynamic patterns of vaping, dual users with lower e-cigarette dependence tend to report higher day-to-day dramatic changes in combustible cigarette consumption but not higher average levels of smoking. CONCLUSIONS We found that more stable use patterns are related to higher levels of dependence, which has been demonstrated in combustible cigarettes and we have now illustrated in e-cigarettes. Furthermore, the e-cigarette dependence scales may capture the product-specific average consumption but not product-specific instability of consumption. IMPLICATIONS This study provides empirical support for three e-cigarette dependence measures: PS-ECDI, e-FTCD, and e-WISDM, based on dynamic patterns of e-cigarette consumption and craving revealed by EMA data that have great ecological validity. This is the first study that introduces novel indices of dynamic patterns and demonstrates their potential applications in vaping research.
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Affiliation(s)
- Anne Buu
- Department of Health Promotion and Behavioral Sciences, University of Texas Health Science Center, Houston, TX, USA
| | - Zhanrui Cai
- Department of Statistics, Pennsylvania State University, University Park, PA, USA
| | - Runze Li
- Department of Statistics, Pennsylvania State University, University Park, PA, USA
| | - Su-Wei Wong
- Department of Health Promotion and Behavioral Sciences, University of Texas Health Science Center, Houston, TX, USA
| | - Hsien-Chang Lin
- Department of Applied Health Science, School of Public Health, Indiana University, Bloomington, IN, USA
| | - Wei-Chung Su
- Department of Epidemiology, Human Genetics & Environmental Sciences, University of Texas Health Science Center, Houston, TX, USA
| | - Douglas E Jorenby
- Center for Tobacco Research & Intervention, University of Wisconsin, Madison, WI, USA
| | - Megan E Piper
- Center for Tobacco Research & Intervention, University of Wisconsin, Madison, WI, USA
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16
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Simpson KA, Kechter A, Schiff SJ, Braymiller JL, Yamaguchi N, Ceasar RC, Bluthenthal RN, Barrington-Trimis JL. Characterizing symptoms of e-cigarette dependence: a qualitative study of young adults. BMC Public Health 2021; 21:959. [PMID: 34016066 PMCID: PMC8138971 DOI: 10.1186/s12889-021-10945-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 04/15/2021] [Indexed: 12/04/2022] Open
Abstract
Background While rates of e-cigarette use (‘vaping’) continue to potentiate concern, there is limited data on common symptoms of e-cigarette dependence among young adults who vape. This study sought to critically explore how young adults experience, manifest, and conceptualize vaping dependence symptoms in their everyday lives. Methods Between June 2018 and 2019, in-depth qualitative interviews were conducted with 62 young adults who use e-cigarettes (aged 18–25) and live in Southern California. We explored participants’ product preferences, daily e-cigarette use patterns, vaping history, withdrawal experiences, and quit attempts or periods of cessation. We used a thematic analysis approach to interpret the transcripts. Results Young adults discussed nine dimensions of vaping dependence that were organized into two categories: 1) general nicotine dependence symptoms, and 2) unique dependence symptoms related to vaping. Nicotine dependence symptoms included cravings and urgency to use, increased use to achieve desired effects, and unsuccessful quit attempts and withdrawal. Symptoms unique to vaping dependence included greater nicotine consumption due to accessibility and lack of restrictions, habitual vaping, inability to track vaping frequency, immediate gratification and comfort, social acceptability and norms, and awareness of vaping dependency. Conclusions In addition to nicotine dependence symptoms that have been characterized for other tobacco products, young adult e-cigarette users described unique symptoms of vaping dependence that necessitate the need for more refined measures. All dimensions of vaping dependence should be considered in discussions of policies as well as treatment and education efforts intended to protect young people from e-cigarette dependence. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10945-z.
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Affiliation(s)
- Kelsey A Simpson
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001 N. Soto Street, Los Angeles, CA, 90089, USA.
| | - Afton Kechter
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001 N. Soto Street, Los Angeles, CA, 90089, USA
| | - Sara J Schiff
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001 N. Soto Street, Los Angeles, CA, 90089, USA
| | - Jessica L Braymiller
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001 N. Soto Street, Los Angeles, CA, 90089, USA.,Institute for Addiction Science, University of Southern California, Los Angeles, CA, USA
| | - Naosuke Yamaguchi
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001 N. Soto Street, Los Angeles, CA, 90089, USA
| | - Rachel Carmen Ceasar
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001 N. Soto Street, Los Angeles, CA, 90089, USA
| | - Ricky N Bluthenthal
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001 N. Soto Street, Los Angeles, CA, 90089, USA.,Institute for Addiction Science, University of Southern California, Los Angeles, CA, USA
| | - Jessica L Barrington-Trimis
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001 N. Soto Street, Los Angeles, CA, 90089, USA.,Institute for Addiction Science, University of Southern California, Los Angeles, CA, USA
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17
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Hammond D, Reid JL, Rynard VL, O'Connor RJ, Goniewicz ML, Piper ME, Bansal-Travers M. Indicators of dependence and efforts to quit vaping and smoking among youth in Canada, England and the USA. Tob Control 2021; 31:tobaccocontrol-2020-056269. [PMID: 33526441 PMCID: PMC8325708 DOI: 10.1136/tobaccocontrol-2020-056269] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 12/14/2020] [Accepted: 12/22/2020] [Indexed: 12/23/2022]
Abstract
OBJECTIVE The current study examined indicators of dependence among youth cigarette smokers and e-cigarette users in Canada, England and the USA, including changes between 2017 and 2019. METHODS Data are from repeated cross-sectional online surveys conducted in 2017, 2018 and 2019 with national samples of youth aged 16-19 years, in Canada (n=12 018), England (n=11 362) and the USA (n=12 110). Measures included perceived addiction to cigarettes/e-cigarettes, frequency of experiencing strong urges to smoke/use an e-cigarette, plans to quit smoking/using e-cigarettes and past attempts to quit. Logistic regression models were fitted to examine differences between countries and changes over time. RESULTS The proportion of ever-users who vaped frequently was significantly higher in 2019 compared with 2017 for all outcomes in each country. Between 2017 and 2019, the proportion of past 30-day vapers reporting strong urges to vape on most days or more often increased in each country (Canada: 35.3%, adjusted OR (AOR) 1.69, 95% CI 1.20 to 2.38; England: 32.8%, AOR 1.55, 1.08 to 2.23; USA: 46.1%, AOR 1.88, 1.41 to 2.50), along with perceptions of being 'a little' or 'very addicted' to e-cigarettes (Canada: 48.3%, AOR 1.99, 1.44 to 2.75; England: 40.1%, AOR 1.44, 1.03 to 2.01; USA: 53.1%, AOR 1.99, 1.50 to 2.63). Indicators of dependence among smokers were consistently greater than e-cigarette users, although differences had narrowed by 2019, particularly in Canada and the USA. CONCLUSIONS Prevalence of dependence symptoms among young e-cigarette users increased between 2017 and 2019, more so in Canada and the USA compared with England. Dependence symptom prevalence was lower for e-cigarettes than smoking; however, the gap has narrowed over time.
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Affiliation(s)
- David Hammond
- School of Public Health & Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Jessica L Reid
- School of Public Health & Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Vicki L Rynard
- School of Public Health & Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Richard J O'Connor
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Maciej L Goniewicz
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Megan E Piper
- Center for Tobacco Research and Intervention, School of Medicine and Public Health, University of Wisconsin Madison, Madison, Wisconsin, USA
| | - Maansi Bansal-Travers
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
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18
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Harlow AF, Hatch EE, Wesselink AK, Rothman KJ, Wise LA. Electronic Cigarettes and Fecundability: Results From a Prospective Preconception Cohort Study. Am J Epidemiol 2021; 190:353-361. [PMID: 32378702 DOI: 10.1093/aje/kwaa067] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 03/11/2020] [Accepted: 03/12/2020] [Indexed: 01/07/2023] Open
Abstract
Although electronic cigarette (e-cigarette) aerosol contains similar toxicants to combustible cigarettes, few studies have examined their influence on fecundability. We assessed the association between e-cigarette use and fecundability, overall and according to combustible cigarette smoking history, in a cohort of 4,586 North American women (aged 21-45 years) enrolled during 2017-2020 in Pregnancy Study Online, a Web-based prospective preconception study. Women reported current and former e-cigarette use on baseline and follow-up questionnaires, and they completed bimonthly follow-up questionnaires until self-reported pregnancy or censoring. Fecundability ratios and 95% confidence intervals were calculated using proportional probabilities models, controlling for potential confounders. Overall, 17% of women had ever used e-cigarettes and 4% were current users. Compared with never use of e-cigarettes, current e-cigarette use was associated with slightly lower fecundability (fecundability ratio = 0.84, 95% confidence interval (CI): 0.67, 1.06). Compared with current nonusers of e-cigarettes and combustible cigarettes, fecundability ratios were 0.83 (95% CI: 0.54, 1.29) for current dual users of e-cigarettes and combustible cigarettes, 0.91 (95% CI: 0.70, 1.18) for current e-cigarette users who were nonsmokers of combustible cigarettes, and 1.01 (95% CI: 0.85, 1.20) for nonusers of e-cigarettes who were current smokers of combustible cigarettes. Current e-cigarette use was associated with slightly reduced fecundability, but estimates of its independent and joint associations with combustible cigarette smoking were inconsistent and imprecise.
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19
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Piper ME, Baker TB, Benowitz NL, Smith SS, Jorenby DE. E-cigarette Dependence Measures in Dual Users: Reliability and Relations With Dependence Criteria and E-cigarette Cessation. Nicotine Tob Res 2020; 22:756-763. [PMID: 30874804 DOI: 10.1093/ntr/ntz040] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Accepted: 03/08/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND Electronic cigarettes (e-cigarettes) have drastically changed the nicotine and tobacco product landscape. However, their potential public health impact is still unclear. A reliable and valid measure of e-cigarette dependence would likely advance assessment and prognostication of the public health impact of e-cigarettes. The aim of this research was to examine the internal consistency, structure, and validity of three e-cigarette dependence scales. METHODS Adult dual users (smokers who also vape, N = 256) enrolled in an observational cohort study (45.1% women, 70.7% white). At baseline, participants completed the e-cigarette Fagerström Test of Cigarette Dependence (e-FTCD), the e-cigarette Wisconsin Inventory of Smoking Dependence Motives (e-WISDM), and the Penn State Electronic Cigarette Dependence Index (PS-ECDI). All participants provided a urine sample for cotinine analysis and reported e-cigarette use at 1 year. RESULTS The e-WISDM subscales had the highest internal consistency (α = .81-.96), then the PS-ECDI (α = .74) and e-FTCD (α = .51). A single-factor structure for the e-FTCD and an 11-factor structure for the e-WISDM were supported, but the PS-ECDI did not have a single-factor structure. All three e-cigarette dependence scales were highly correlated with validation criteria including continued e-cigarette use at 1 year, but not with e-liquid nicotine concentration or cotinine. CONCLUSIONS The e-WISDM and PS-ECDI had stronger internal consistency than did the e-FTCD, despite the e-FTCD's single-factor structure, but all 3 measures appear to be valid measures of e-cigarette dependence as suggested by their significant relations with self-perceived addiction, heavy use, early use after overnight deprivation, and continued use over time. IMPLICATIONS This research provides empirical support for three e-cigarette dependence measures: the e-FTCD, the PS-ECDI, and the e-WISDM among dual users of e-cigarettes and combustible cigarettes. The PS-ECDI and e-WISDM are more reliable, but all three measures were strongly correlated with key dependence constructs such as heavy use and continued use over time.
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Affiliation(s)
- Megan E Piper
- Department of Medicine, Center for Tobacco Research and Intervention, School of Medicine and Public Health, University of Wisconsin, Madison, WI
| | - Timothy B Baker
- Department of Medicine, Center for Tobacco Research and Intervention, School of Medicine and Public Health, University of Wisconsin, Madison, WI
| | - Neal L Benowitz
- Department of Medicine and Center for Tobacco Control Research and Education, University of California San Francisco, San Francisco, CA
| | - Stevens S Smith
- Department of Medicine, Center for Tobacco Research and Intervention, School of Medicine and Public Health, University of Wisconsin, Madison, WI
| | - Douglas E Jorenby
- Department of Medicine, Center for Tobacco Research and Intervention, School of Medicine and Public Health, University of Wisconsin, Madison, WI
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Kopel J, Dennis JA, Nugent K. Electronic cigarette survey characteristics. J Community Hosp Intern Med Perspect 2020; 10:216-223. [PMID: 32850068 PMCID: PMC7426995 DOI: 10.1080/20009666.2020.1766841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Introduction Electronic cigarettes (EC) remain a controversial topic with uncertainty about harm reduction in current smokers, their efficacy in smoking cessation, their potential for addiction, the need for regulation, and the type of information needed to educate the public about the benefits and hazards of EC. Multiple medical institutions and organizations have conducted surveys to investigate the demographics and perceptions of EC consumers in adult and youth populations. However, it is unknown whether these surveys use consistent, reliable, or accurate measures for EC use. Methods We analyzed 13 survey articles identified during a review of the use of EC during smoking cessation programs to determine the characteristic features of the surveys and to determine how frequently they satisfied the measurement of important core items suggested by recent articles. Results Our analysis focused on 13 studies. These studies represented the work of 13 separate research groups and were published in 10 different biomedical journals with a median impact factor score of 4.1. The median number of participants in the studies was 2,624 (Q1-Q3: 662-6,356); the number of participants ranged from 179 to 19,414. The median number of e-cigarette users in the surveys was 840 (Q1-Q3: 256-3,849). All studies provided clear study goals in their introduction. Five surveys used on-line methods to collect information; four studies provided limited information about the reliability of their data. All studies reported study outcomes and considered limitations. Five studies had limited external validity. None of the surveys collected a complete set of core information recommended by recent authorities on survey methodology for EC. Conclusions The surveys reviewed in this project had significant variability in study design, survey population, and study goals. Consequently, comparisons across studies become difficult and limit the external validity of survey studies on EC.
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Affiliation(s)
- Jonathan Kopel
- Department of Cell Biology and Biochemistry, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Jeff A Dennis
- Department of Public Health, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Kenneth Nugent
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
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21
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Olonoff M, Niaura R, Hitsman B. "Electronic Cigarettes" Are Not Cigarettes, and Why That Matters. Nicotine Tob Res 2020; 21:1441-1444. [PMID: 30265351 DOI: 10.1093/ntr/nty205] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 09/24/2018] [Indexed: 11/13/2022]
Abstract
As the prevalence rates of cigarette use have declined over the past decade, use of electronic cigarettes (e-cigarettes) continues to increase, and companies are heavily invested in manufacturing new e-cigarette products. Scientists are therefore studying e-cigarette use at a rapid rate, generally by conceptualizing e-cigarettes as similar to traditional cigarettes in their use and effects. Thinking of e-cigarettes as largely comparable with cigarettes, however, fails to capture the unique e-cigarette capabilities, user experiences, and effects on nicotine dependence and even health. Assuming that e-cigarette users puff on their devices as they do cigarettes to attain doses of nicotine comparable in magnitude and asking questions about e-cigarette use modeled after how smoking behavior has been usually assessed (eg, puff number, duration, number of cigarettes per day) may miss important differences. A greater appreciation of the distinct uniqueness of e-cigarettes, as compared with cigarettes, will help to accelerate innovative research on e-cigarettes and other electronic devices, leading to new theoretical models and behavioral measures. IMPLICATIONS With research about electronic cigarettes (e-cigarettes) rapidly increasing, this commentary addresses the conceptualization of e-cigarettes as similar to traditional cigarettes. The more we attempt to understand and measure e-cigarettes as equivalent to cigarettes, the more likely research may err in conclusions about these unique devices. Our commentary notes how using unique conceptualizations and measures for e-cigarettes will help accelerate new research.
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Affiliation(s)
- Matthew Olonoff
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Raymond Niaura
- Department of Social and Behavioral Sciences, College of Global Public Health, New York University, New York, NY
| | - Brian Hitsman
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL
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22
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Pericot-Valverde I, Priest JS, Wagener TL, Gaalema DE. Examination of a mouthpiece-based topography device for assessing relative reinforcing effects of e-cigarettes: A preliminary study. Exp Clin Psychopharmacol 2020; 28:13-18. [PMID: 31305091 PMCID: PMC7261006 DOI: 10.1037/pha0000288] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The assessment of vaping topography has helped to identify characteristics associated with distinct vaping patterns. Available puff topography devices do not alter the subjective effects of vaping. However, one central construct related to drug abuse, unexplored in prior studies, is whether relative reinforcing effects (RRE) of vaping change when using a topography device. We examined the RRE of vaping when individuals vape through an e-cigarette with a mouthpiece topography device attached versus their own e-cigarette. Associations of demand indices for participants' own e-cigarette and for a research e-cigarette with a topography device were also explored. Forty-three e-cigarette users attended 1 experimental session where they completed 2 purchase tasks in different units of consumption, ml and puffs, with their preferred e-cigarette and with an e-cigarette with a mouthpiece. Puff topography was measured in the mouthpiece condition. All four purchase tasks showed the predicted inverse relationship between purchase and price. No differences in most demand indices were observed between both e-cigarettes, except for breakpoint (lowest price that suppresses consumption) and Omax (maximum expenditure) in ml units which both decreased when participants vaped through the mouthpiece device. Demand indices in ml units were more strongly associated. Data from the purchase tasks suggests that the presence of a mouthpiece topography device does not influence the RRE of vaping among e-cigarette users. Demand for e-cigarettes seems more consistent in ml units. Our results further evidence that mouthpiece topography devices represent a valid and reliable instrument to study RRE of e-cigarettes and, by extension, abuse liability. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
- Irene Pericot-Valverde
- Vermont Center on Behavior and Health, University of Vermont, Burlington, VT,Department of Psychiatry, University of Vermont, Burlington, VT
| | - Jeff S. Priest
- Vermont Center on Behavior and Health, University of Vermont, Burlington, VT,Department of Biostatistical Unit, University of Vermont, Burlington, VT
| | - Theodore L. Wagener
- Department of Pediatrics, University of Oklahoma Health Sciences Center Oklahoma City, OK
| | - Diann E. Gaalema
- Vermont Center on Behavior and Health, University of Vermont, Burlington, VT,Department of Psychiatry, University of Vermont, Burlington, VT
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Pericot-Valverde I, Yoon JH, Gaalema DE. Single- and cross-commodity delay discounting of money and e-cigarette liquid in experienced e-cigarette users. Drug Alcohol Depend 2020; 206:107740. [PMID: 31778948 PMCID: PMC7250042 DOI: 10.1016/j.drugalcdep.2019.107740] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Revised: 11/05/2019] [Accepted: 11/11/2019] [Indexed: 11/18/2022]
Abstract
BACKGROUND Delay discounting (DD) research has improved our understanding of important behavioral processes associated with tobacco use. Little research has explored DD among e-cigarette users, and these studies have exclusively examined money as the only available commodity. This secondary analysis of a laboratory study explored discounting for money and e-liquid among e-cigarette users using two single-commodity discounting (SCD) tasks and one cross-commodity discounting (CCD) task. A secondary goal was to explore the extent to which results from the SCD and CCD tasks were correlated to each other and with measures of e-cigarette use. METHODS E-cigarette users (N = 27) completed two SCD tasks and one CCD task. The SCD tasks assessed choices between various amounts of either money now versus money later (M-M) or e-liquid now versus e-liquid later (mL-mL). The CCD task assessed choices between e-liquid now versus money later (mL-M). Discounting results were compared using logk and AUClog. RESULTS Discounting was greatest in the mL-mL task, followed by the M-M task, and then the mL-M task. AUClog and logk were significantly correlated across all discounting tasks. Attempts to quit vaping was positively associated with logk and negatively associated with AUClog and in both SCD tasks. CONCLUSIONS E-cigarette users discount e-liquid more than money in a SCD task. However, when the two commodities, money and e-liquid (CCD), are compared the substance of abuse is discounted to a lesser extent. Interventions that provide alternative reinforcers to compete with the reinforcing effects of nicotine intake may be especially indicated for treating e-cigarette dependence.
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Affiliation(s)
- Irene Pericot-Valverde
- School of Health Research, Clemson University, 605 Grove Road, Greenville, SC 29605, United States; Prisma Health-Upstate, Department of Internal Medicine, 701 Grove Road, Greenville, SC 29605, United States.
| | - Jin H Yoon
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, 1941 East Road, Houston, TX 77054, United States
| | - Diann E Gaalema
- Vermont Center on Behavior and Health, 1 South Prospect Street, University of Vermont, Burlington, VT 05401, United States; Departments of Psychology and Psychiatry, 1 South Prospect Street, University of Vermont, Burlington, VT 05401, United States
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Leventhal AM, Goldenson NI, Aguirre CG, Huh J, Kirkpatrick MG. Initial application of a human laboratory model for estimating the motivational substitutability of e-cigarettes for combustible cigarettes. Exp Clin Psychopharmacol 2019; 27:125-135. [PMID: 30688503 PMCID: PMC6599596 DOI: 10.1037/pha0000237] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
This pilot study tested a novel human laboratory model for estimating the extent to which electronic cigarettes (e-cigarettes) serve as motivational substitutes for combustible cigarettes. The model assesses 3 parameters of substitutability, including the: (a) increase in motivational reward value of e-cigarettes after tobacco deprivation; (b) reduction in the reward value of combustible cigarettes after e-cigarette administration; and (c) comparability of the withdrawal-suppressing effects of e-cigarettes versus combustible cigarettes. Dual users (daily smokers, vaped 4+ days/week, M age = 35.3) attended 4 visits after 16-h tobacco product abstinence. For 2 visits, participants completed withdrawal measures and a task assessing smoking's reward value preceded by either: satiation by vaping or sustained tobacco product deprivation. For 2 other visits, participants completed withdrawal measures and a task assessing vaping's reward value preceded by either: continued deprivation versus satiation by smoking. Tobacco product deprivation (vs. satiation by smoking) increased vaping's reward value, indicated by nonsignificantly greater likelihood of initiating vaping versus abstaining for money (d = -.26; adjusted p [padj] = .08) and more vaping episodes purchased (β = .22; padj = .08). Satiation by vaping (vs. deprivation) nonsignificantly reduced smoking initiation (d = .46; padj = .09) and significantly decreased number of cigarettes purchased (β = -.29; padj = .04). Relative to deprivation, vaping suppressed withdrawal-related negative affect, smoking and vape urge, and anhedonia (ds ≥ .54). The magnitude of vaping-induced and smoking-induced withdrawal suppression did not significantly differ for all outcomes other than smoking urge, which was more strongly reduced by smoking (d = -1.57) than vaping (d = -.64). Future application and extension of this model may advance tobacco regulatory science and policy addressing e-cigarette use among smokers. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
- Adam M Leventhal
- Department of Preventive Medicine, University of Southern California Keck School of Medicine
| | - Nicholas I Goldenson
- Department of Preventive Medicine, University of Southern California Keck School of Medicine
| | - Claudia G Aguirre
- Department of Preventive Medicine, University of Southern California Keck School of Medicine
| | - Jimi Huh
- Department of Preventive Medicine, University of Southern California Keck School of Medicine
| | - Matthew G Kirkpatrick
- Department of Preventive Medicine, University of Southern California Keck School of Medicine
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