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Soule E, Bansal-Travers M, Grana R, McIntosh S, Price S, Unger JB, Walton K. Electronic cigarette use intensity measurement challenges and regulatory implications. Tob Control 2023; 32:124-129. [PMID: 34059553 PMCID: PMC8630087 DOI: 10.1136/tobaccocontrol-2021-056483] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 04/19/2021] [Accepted: 04/20/2021] [Indexed: 11/04/2022]
Abstract
Assessing tobacco use intensity allows researchers to examine tobacco use in greater detail than assessing ever or current use only. Tobacco use intensity measures have been developed that are specific to tobacco products, such as asking smokers to report number of cigarettes smoked per day. However, consensus on electronic cigarette use intensity measures that can be used for survey research has yet to be established due to electronic cigarette product and user behavior heterogeneity. While some survey measures that attempt to assess electronic cigarette use intensity exist, such as examining number of 'times' using an electronic cigarette per day, number of puffs taken from an electronic cigarette per day, volume of electronic cigarette liquid consumed per day, or nicotine concentration of electronic cigarette liquid, most measures have limitations. Challenges in electronic cigarette measurement often stem from variations across electronic cigarette device and liquid characteristics as well as the difficulty that many electronic cigarette users have regarding answering questions about their electronic cigarette device, liquid, or behavior. The inability for researchers to measure electronic cigarette use intensity accurately has important implications such as failing to detect unintended consequences of regulatory policies. Development of electronic cigarette use intensity measures, though not without its challenges, can improve understanding of electronic cigarette use behaviors and associated health outcomes and inform development of regulatory policies.
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Affiliation(s)
- Eric Soule
- Department of Health Education and Promotion, East Carolina University, Greenville, North Carolina, USA
| | | | - Rachel Grana
- Tobacco Control Research Branch, National Cancer Institute, Rockville, Maryland, USA
| | - Scott McIntosh
- Public Health Sciences, University of Rochester, Rochester, New York, USA
| | - Simani Price
- Public Health and Epidemiology Practice, Westat, Center for Coordination of Analytics, Science, Enhancement, and Logistics, Rockville, Maryland, USA
| | - Jennifer B Unger
- Preventive Medicine, University of Southern California, Los Angeles, California, USA
| | - Kevin Walton
- Division of Therapeutics and Medical Consequences, National Institute on Drug Abuse, Bethesda, Maryland, USA
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2
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Lin LY, Chien YN, Chen YH, Shean R, Wu CY, Huang SC, Chiou HY. E-cigarettes and smoking cessation among adolescent smokers. Sci Rep 2022; 12:19489. [PMID: 36376363 PMCID: PMC9663538 DOI: 10.1038/s41598-022-22344-4] [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: 05/07/2022] [Accepted: 10/13/2022] [Indexed: 11/16/2022] Open
Abstract
Smokers of any age can reap substantial health benefits from quitting or reducing their smoking. E-cigarettes have been promoted as a potentially promising product for tobacco harm reduction because e-cigarettes deliver nicotine vapor without many of the hazardous chemical combustion byproducts produced by combustible cigarette smoking. However, there remains an ongoing debate on whether the use of e-cigarettes is effective in combustible cigarette smoking cessation or reduction in both adolescents and adults. Our study uses data from the 2015 (baseline) and from the 2017 (follow-up) waves of the Taiwan Adolescent to Adult Longitudinal Study (TAALS), which is a large nationwide representative cohort study of health behaviors among adolescents in Taiwan. We analyzed the data using logistic regression and multivariate regression with a post-stratification weighting procedure. Among the 474 adolescent combustible cigarette users at baseline, the use of e-cigarettes had no association with smoking cessation (aRR = 0.99, 95% CI = 0.66, 1.50). Furthermore, the use of e-cigarettes was also not associated with change in combustible cigarette consumption among all adolescent combustible cigarette users at follow-up (Coef. = 0.62, 95% CI = - 36.85, 38.09). In summary, our findings suggest that e-cigarettes may not aid tobacco control among adolescent smokers. Policy makers should be cautious of the potential harms that e-cigarette may bring to young people when they are developing e-cigarette regulations.
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Affiliation(s)
- Li-Yin Lin
- grid.412146.40000 0004 0573 0416Department of Leisure Industry and Health Promotion, National Taipei University of Nursing and Health Sciences, 365 MingDe Road, Beitou District, Taipei, 11219 Taiwan
| | - Yu-Ning Chien
- grid.419832.50000 0001 2167 1370Department of Health and Welfare, University of Taipei, Taipei, Taiwan
| | - Yi-Hua Chen
- grid.412896.00000 0000 9337 0481School of Public Health, College of Public Health, Taipei Medical University, 250 Wuxing St, Xinyi Dist., Taipei City, 110 Taiwan
| | - Russell Shean
- grid.412896.00000 0000 9337 0481Master in Global Health and Development Program, College of Public Health, Taipei Medical University, 250 Wuxing St., Taipei City, 110 Taiwan
| | - Chi-Yi Wu
- grid.59784.370000000406229172Institute of Population Health Sciences, National Health Research Institutes, Zhunan Town, Miaoli County, 35053 Taiwan
| | - Shih-Chang Huang
- grid.511551.40000 0004 0639 2797Chung-Hua Institution for Economic Research, No.75, Changxing St., Da-an Dist., Taipei City, 106 Taiwan
| | - Hung-Yi Chiou
- grid.59784.370000000406229172Institute of Population Health Sciences, National Health Research Institutes, Zhunan Town, Miaoli County, 35053 Taiwan ,grid.412896.00000 0000 9337 0481School of Public Health, College of Public Health, Taipei Medical University, 250 Wuxing St, Taipei City, 110 Taiwan
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Yang J, Kuo J, Su WC, Jorenby DE, Piper ME, Buu A. A new statistical model for longitudinal ecological momentary assessment data on dual use of electronic and combustible cigarettes. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2022; 48:529-537. [PMID: 35100512 PMCID: PMC10201566 DOI: 10.1080/00952990.2022.2027955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 01/04/2022] [Accepted: 01/07/2022] [Indexed: 01/31/2023]
Abstract
Background: Existing studies of dual use of electronic and combustible cigarettes either collected longitudinal data with long gaps in between waves or conducted ecological momentary assessment (EMA) over a short period of time. In recent years, the measurement burst design that embeds an EMA protocol in each wave assessment of a traditional longitudinal study has become more popular and yet conventional generalized linear mixed models (GLMM) have important limitations for handling data from this design.Objectives: This study proposed a new statistical method to analyze data from the measurement burst design.Methods: This new statistical method was designed to model the short-term (within-wave) as well as long-term (between-wave) changes and was validated by a simulation study. Secondary analysis was conducted to analyze data from 205 dual users (52% male) and 146 exclusive smokers (50% male) who participated in a recent study using the measurement burst design.Results: The simulation study shows that the proposed method can handle the gap between waves well and is also robust to nonlinear changes across waves. Although no short-term change in smoking was found, dual users reported a long-term reduction in cigarette use that was more rapid compared to exclusive smokers (β ˆ = - 0.0127 , p = .0167 ). Vaping more was associated with smoking less (β ˆ = - 0.0058 , p = .0054 ).Conclusion: The proposed method is highly applicable as it can be easily implemented by substance use researchers and the results can be straightforwardly interpreted. The results suggest that e-cigarette use may play a role in promoting a long-term reduction in smoking among dual users.
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Affiliation(s)
- James Yang
- Department of Biostatistics & Data Science, University of Texas Health Science Center, 1200 Pressler St., Houston, TX 77030, USA
| | - Jacky Kuo
- Department of Biostatistics & Data Science, University of Texas Health Science Center, 1200 Pressler St., Houston, TX 77030, USA
| | - Wei-Chung Su
- Department of Epidemiology, Human Genetics & Environmental Sciences, University of Texas Health Science Center, 1200 Pressler St., Houston, TX 77030, USA
| | - Douglas E. Jorenby
- Center for Tobacco Research & Intervention, University of Wisconsin, 1930 Monroe Street, Suite 200, Madison, WI 53711, USA
| | - Megan E. Piper
- Center for Tobacco Research & Intervention, University of Wisconsin, 1930 Monroe Street, Suite 200, Madison, WI 53711, USA
| | - Anne Buu
- Department of Health Promotion and Behavioral Sciences, University of Texas Health Science Center, 7000 Fannin St., Houston, TX 77030, USA
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Watson CV, Alexander DS, Oliver BE, Trivers KF. Substance use among adult marijuana and nicotine e-cigarette or vaping product users, 2020. Addict Behav 2022; 132:107349. [PMID: 35580371 PMCID: PMC11056937 DOI: 10.1016/j.addbeh.2022.107349] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 04/28/2022] [Accepted: 04/30/2022] [Indexed: 11/01/2022]
Abstract
INTRODUCTION Co-use of marijuana and tobacco/nicotine have unknown impacts on addiction and health. There are limited data on the extent to which adults are co-using tetrahydrocannabinol (THC)- and nicotine-containing products, in any of their various modes. This study describes adult use of THC- and nicotine-containing products among electronic vaping product (EVP) users. METHODS Data on marijuana and tobacco use were collected from February 25-29, 2020 through an online survey of adults aged ≥18 years who reported using THC- and nicotine-containing electronic vaping products (EVPs) in the past 3 months (n = 3,980). Survey respondents from 18 states participated in the U.S. YouGov panel, a proprietary opt-in internet panel survey of 1.8 million U.S. residents. RESULTS Among those who reported using nicotine and THC-containing EVPs in the past 3 months, 90.1% of respondents reported smoking marijuana in the past 3 months; 82.7% reported smoking as the most frequent mode of marijuana use. Almost 63% of EVP users reported smoking cigarettes; 55.6% reported smoking for over 8 years, while 7.7% had been smoking cigarettes for under a year. CONCLUSIONS In this study, respondents reported cigarette smoking and marijuana smoking in addition to using marijuana- and nicotine- containing EVPs. Considering the unknown health effects of co-use of tobacco and THC-containing products, the finding that adults are vaping THC and nicotine alongside traditional modes of marijuana and tobacco use of these substances warrants further investigation. IMPLICATIONS Findings from this study provide evidence that adults who use nicotine and THC EVPs are also using a variety of other THC-containing and tobacco-containing products. This indicates the importance of continued surveillance to assess trends of polysubstance EVP and multi-modal marijuana and tobacco use. Monitoring various modes of marijuana and tobacco use may inform policies, prevention education, communication, and cessation tools.
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Affiliation(s)
- Christina V Watson
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, CDC, United States.
| | - Dayna S Alexander
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, CDC, United States
| | - Briana E Oliver
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, CDC, United States
| | - Katrina F Trivers
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, CDC, United States
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van der Eijk Y, Tan Ping Ping G, Ong SE, Tan Li Xin G, Li D, Zhang D, Min Shuen L, Kee Seng C. E-Cigarette Markets and Policy Responses in Southeast Asia: A Scoping Review. Int J Health Policy Manag 2022; 11:1616-1624. [PMID: 33906338 PMCID: PMC9808234 DOI: 10.34172/ijhpm.2021.25] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 03/13/2021] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND The global e-cigarette market has proliferated and is increasingly dominated by transnational tobacco companies. While Southeast Asian countries have received relatively little attention in e-cigarette research, the region represents an area of potentially untapped growth for the industry. We review the e-cigarette situation in Southeast Asia in terms of the e-cigarette markets, advertising and promotion of e-cigarettes, reported health impacts of e-cigarette use, and policy responses in the region. METHODS We examined e-cigarette market data from the Euromonitor Global Market Information Database (GMID) Passport database, searched in the academic literature, grey literature and news archives for any reports or studies of e-cigarette related diseases or injuries, e-cigarette marketing, and e-cigarette policy responses in Southeast Asian countries, and browsed the websites of online e-cigarette retailers catering to the region's active e-cigarette markets. RESULTS In 2019, e-cigarettes were sold in six Southeast Asian markets with a total market value of $595 million, projected to grow to $766 million by 2023. E-commerce is a significant and growing sales channel in the region, with most of the popular or featured brands in online shops originating from China. Southeast Asian youth are targeted with a wide variety of flavours, trendy designs and point of sale promotions, and several e-cigarette related injuries and diseases have been reported in the region. Policy responses vary considerably between countries, ranging from strict bans to no or partial regulations. CONCLUSION Although Southeast Asia's e-cigarette market is relatively nascent, this is likely to change if transnationals invest more heavily in the region. Populous countries with weak e-cigarette regulations, notably Indonesia, Malaysia, Vietnam and the Philippines, are desirable targets for the transnationals. Regulatory action is needed to prevent e-cigarette use from becoming entrenched into these societies, especially among young people.
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Affiliation(s)
- Yvette van der Eijk
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Grace Tan Ping Ping
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Suan Ee Ong
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
- Research for Impact, Singapore, Singapore
| | - Grace Tan Li Xin
- Department of Political Science, Faculty of Arts and Social Sciences, National University of Singapore, Singapore, Singapore
| | - David Li
- Department of Civil and Environmental Engineering, Faculty of Engineering, University of Alberta, Edmonton, AB, Canada
| | - Dijin Zhang
- Department of Biological Sciences, Faculty of Science, National University of Singapore, Singapore, Singapore
| | - Loo Min Shuen
- Department of Psychology, Faculty of Arts and Social Sciences, National University of Singapore, Singapore, Singapore
| | - Chia Kee Seng
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
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Sutton SK, Brandon KO, Harrell PT, Martínez Ú, Simmons VN, Gore LR, Bullen CR, Brandon TH. Identifying prospective subpopulations of combustible and electronic cigarette dual users in the United States via finite mixture modeling. Addiction 2022; 117:2493-2503. [PMID: 35491736 PMCID: PMC9795793 DOI: 10.1111/add.15906] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 04/01/2022] [Indexed: 12/30/2022]
Abstract
AIMS To identify subpopulations of dual users of combustible and electronic cigarettes using current smoking and vaping behaviors. DESIGN Secondary analysis of baseline data from a randomized controlled trial testing a smoking cessation intervention for dual users. Finite mixture modeling of frequency, quantity, and dependence on combustible and electronic cigarettes was used to identify classes. Demographics and additional smoking and vaping variables were used to further characterize the classes. SETTING United States. PARTICIPANTS A total of 2896 adults who smoked weekly for the past year and vaped weekly for the past month. MEASUREMENTS Self-report baseline measures assessed demographics and smoking and vaping behaviors and characteristics including days of use per week, frequency of use within a day, time to first use after waking, urges to smoke, smoking cessation motivation, self-efficacy to abstain from smoking, months since vaping initiation, reasons for initiating and maintaining vaping, and future plans to stop vaping. FINDINGS Eight probabilistic classes were identified and well-defined (relative entropy = 0.95, Lo-Mendell-Rubin adjusted likelihood ratio test P < 0.0001; class probabilities 0.89-0.97). In general, classes crossed two levels of smoking with four levels of vaping. The largest class (31%) had relatively high levels of smoking (72% daily, 56% 11+ cigarettes per day [CPD], 96% within 30 minutes of waking) and vaping (74% daily, 100% 20+ electronic-CPD, 74% <30 minutes). The next largest class (27%) had relatively high levels of vaping (93% daily, 100% 20+ electronic-CPD, 82% <30 minutes) and very low levels of smoking (28% daily, 12% 11+ CPD, 0% <30 minutes). The six smaller classes (3%-13%) also had distinct smoking and vaping behaviors. All eight classes exhibited distinguishing characteristics beyond current smoking and vaping behaviors. CONCLUSIONS Dual users of combustible and electronic cigarettes are not a homogeneous population, having eight well-defined prospective subpopulations.
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Affiliation(s)
- Steven K. Sutton
- Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center, Tampa, FL, USA
- Department of Oncologic Sciences, University of South Florida, Tampa, FL, USA
- Department of Psychology, University of South Florida, Tampa, FL, USA
| | - Karen O. Brandon
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, FL, USA
| | - Paul T. Harrell
- Department of Pediatrics, Eastern Virginia Medical School, Norfolk, VA, USA
| | - Úrsula Martínez
- Department of Oncologic Sciences, University of South Florida, Tampa, FL, USA
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, FL, USA
| | - Vani N. Simmons
- Department of Oncologic Sciences, University of South Florida, Tampa, FL, USA
- Department of Psychology, University of South Florida, Tampa, FL, USA
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, FL, USA
| | - L. Robert Gore
- Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center, Tampa, FL, USA
| | - Christopher R. Bullen
- School of Population Health, Faculty of Medical and Health Science, University of Auckland, Auckland, New Zealand
| | - Thomas H. Brandon
- Department of Oncologic Sciences, University of South Florida, Tampa, FL, USA
- Department of Psychology, University of South Florida, Tampa, FL, USA
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, FL, USA
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Johnson AC, Mercincavage M, Souprountchouk V, Sidhu AK, Villanti AC, Delnevo CD, Strasser AA. Construct validity of the Cigarette Ratings Scale and associations with tobacco use and product feature outcomes. Drug Alcohol Depend 2022; 234:109397. [PMID: 35287035 PMCID: PMC9018530 DOI: 10.1016/j.drugalcdep.2022.109397] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 03/02/2022] [Accepted: 03/04/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Subjective ratings are inconsistently associated with behavioral outcomes such as tobacco use and there is no current standard. The Cigarette Ratings Scale is an ideal measure for further evaluation because it has been widely used in tobacco regulatory science and tobacco industry research. PURPOSE This study investigated the construct validity of the Cigarette Ratings Scale and associations with tobacco use and product feature outcomes. METHODS Using secondary analysis of baseline data from five research trials, we conducted an exploratory factor analysis in one sample and validated the factor solution in a second sample. We then examined the relationship of the averaged subscales with tobacco outcomes and cigarette product features among current adult cigarette smokers (N = 752) who smoked ≥ 5 cigarettes daily for ≥ 5 years. RESULTS The results supported a three-factor solution: 1. Product harshness evaluation, 2. Smoking satisfaction, and 3. Positive sensory experience. Multivariable general linear models indicated that cigarettes per day was associated with a lower harshness rating b = -0.29 (95% CI: -0.51, -0.07) and higher positive sensory experience b = 0.32 (95% CI: 0.08, 0.56). FTND average dependence scores were associated with a more positive sensory experience b = 1.08 (95% CI: 0.28, 1.89). CO boost was associated with smoking satisfaction b = 0.77 (95% CI: 0.30, 1.26). CONCLUSIONS The Cigarette Ratings Scale subscales were primarily associated with behavioral outcomes, biological exposure, and nicotine dependence. This can help addiction efforts to determine how subjective evaluations of tobacco products relate to use behaviors.
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Affiliation(s)
- Andrea C Johnson
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; University of Pennsylvania-Rutgers University Tobacco Center of Regulatory Science, Philadelphia, PA, USA.
| | - Melissa Mercincavage
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; University of Pennsylvania-Rutgers University Tobacco Center of Regulatory Science, Philadelphia, PA, USA
| | - Valentina Souprountchouk
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; University of Pennsylvania-Rutgers University Tobacco Center of Regulatory Science, Philadelphia, PA, USA
| | - Anupreet K Sidhu
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; University of Pennsylvania-Rutgers University Tobacco Center of Regulatory Science, Philadelphia, PA, USA
| | - Andrea C Villanti
- University of Pennsylvania-Rutgers University Tobacco Center of Regulatory Science, Philadelphia, PA, USA; Rutgers Center for Tobacco Studies, Rutgers University, New Brunswick, NJ, USA
| | - Cristine D Delnevo
- University of Pennsylvania-Rutgers University Tobacco Center of Regulatory Science, Philadelphia, PA, USA; Rutgers Center for Tobacco Studies, Rutgers University, New Brunswick, NJ, USA
| | - Andrew A Strasser
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; University of Pennsylvania-Rutgers University Tobacco Center of Regulatory Science, Philadelphia, PA, USA; Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA, USA
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Nagi R, Muthukrishnan A, Reddy S, Nagaraju R. Electronic cigarettes use and pharmacological strategies as an intervention for tobacco cessation: Myth or reality? JOURNAL OF INDIAN ACADEMY OF ORAL MEDICINE AND RADIOLOGY 2022. [DOI: 10.4103/jiaomr.jiaomr_246_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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9
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Zvolensky MJ, Manning K, Garey L, Alfano CA, Mayorga NA, Peraza N. Emotion dysregulation, fatigue, and electronic cigarette expectancies. Cogn Behav Ther 2021; 50:138-153. [PMID: 33006499 PMCID: PMC7916989 DOI: 10.1080/16506073.2020.1819868] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 09/02/2020] [Indexed: 10/23/2022]
Abstract
Emotion dysregulation and the experience of fatigue have both been linked to the maintenance of substance use. However, limited empirical data has evaluated individual differences in these constructs in terms of e-cigarette use expectancies. The present study examined a theoretically relevant model focused on whether the experience of more severe fatigue explains, in part, the relation between individual differences in emotion dysregulation and positive and negative e-cigarette expectancies among 525 adult e-cigarette users (50.9% female, Mage = 35.25 years, SD = 10.10). It was hypothesized that emotion dysregulation, via fatigue severity, would significantly predict greater positive and negative e-cigarette expectancies, which was examined in two separate mediation models. Fatigue severity significantly explained, in part, the relation between emotion dysregulation and positive (b = 0.02, CI [0.01, 0.02]) and negative expectancies of e-cigarette use (b = 0.02, 95% CI [0.02, 0.03]). The current findings suggest that the experience of fatigue helps explain the relation between emotion dysregulation and positive and negative e-cigarette expectancies among adult e-cigarette users. Future work is needed to explicate how reducing fatigue severity in the context of emotion dysregulation may change expectancies about e-cigarette expectancies.
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Affiliation(s)
- 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
- Department of Psychology, HEALTH Institute, University of Houston, Houston, TX, USA
| | - Kara Manning
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Lorra Garey
- Department of Psychology, University of Houston, Houston, TX, USA
| | | | - Nubia A. Mayorga
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Natalia Peraza
- Department of Psychology, University of Houston, Houston, TX, USA
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10
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Watson NL, Mull KE, Bricker JB. The association between frequency of e-cigarette use and long-term smoking cessation outcomes among treatment-seeking smokers receiving a behavioral intervention. Drug Alcohol Depend 2021; 218:108394. [PMID: 33203525 PMCID: PMC8104076 DOI: 10.1016/j.drugalcdep.2020.108394] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 10/07/2020] [Accepted: 10/25/2020] [Indexed: 11/20/2022]
Abstract
INTRODUCTION A growing body of literature suggests daily, but not non-daily, e-cigarette use is associated with greater odds of quitting combustible cigarettes in the general adult population. However, it is unknown if these findings generalize to treatment-seeking smokers who are receiving a behavioral intervention. Our primary aim was to examine whether frequency of e-cigarette use was associated with subsequent cessation among treatment-seeking smokers who are receiving a behavioral smoking cessation intervention. METHODS Participants (N = 2637) enrolled in a RCT of web-based smoking treatments reported their use of e-cigarettes at baseline, 3-, and 6-months. Three groups were created based on e-cigarette use: (1) non-users, (2) intermittent users, and (3) daily users. The primary outcome was complete-case, self-reported 30-day point prevalence abstinence at 12 months. RESULTS Compared to non-users, daily e-cigarette users were significantly less likely to be abstinent (21.39 % vs. 29.68 %; p = .006). Quit rates for intermittent users (24.56 %) were not significantly different from non-users (p = .092). Nicotine dependence moderated the results such that among smokers with low nicotine dependence, those who used e-cigarettes (intermittently or daily) were less likely to quit than non-users; these differences were not significant among those with high nicotine dependence. Post hoc analyses indicated that initiating daily e-cigarette use after baseline, but not daily e-cigarette use at baseline, was associated with lower odds of cessation. CONCLUSIONS Daily e-cig use may be associated with lower odds of quitting smoking among treatment-seeking smokers, particularly among those with lower nicotine dependence and who initiate daily use after beginning an intervention.
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Affiliation(s)
- Noreen L Watson
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave N, M3-B232, Seattle, WA 98109, USA.
| | - Kristin E Mull
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave N, M3-B232, Seattle, WA 98109, USA
| | - Jonathan B Bricker
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave N, M3-B232, Seattle, WA 98109, USA; Department of Psychology, University of Washington, 119A Guthrie Hall, Seattle, WA, 98195, USA
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11
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Maier LJ, Ramo DE, Kaur M, Meacham MC, Satre DD. Factors associated with readiness to quit smoking among young adults enrolled in a Facebook-based tobacco and alcohol intervention study. Addict Behav 2020; 111:106524. [PMID: 32791434 PMCID: PMC8262102 DOI: 10.1016/j.addbeh.2020.106524] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 06/15/2020] [Accepted: 06/23/2020] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Young adults who smoke cigarettes often report heavy episodic drinking (HED) and co-use of other psychoactive substances which may complicate efforts to quit cigarette smoking. The current study examined factors associated with readiness to quit cigarette smoking among young adults who smoke and engage in HED. METHODS One hundred seventy-nine young adults aged 18 to 25 who reported regular cigarette smoking and past month HED enrolled in the 90-day Facebook-based Smoking Tobacco and Drinking (STAND) intervention study. Analyses compared baseline differences in patterns of cigarette smoking and alcohol and cannabis use, thoughts about abstinence, use of nicotine replacement therapy (NRT), sociodemographic characteristics, and other health behaviors between participants who were ready to quit cigarette smoking in the next 30 days and those who were not. RESULTS Participants were 40.2% female, 49.7% male, 10.1% non-binary, and 80.4% Non-Hispanic White. They reported on average moderate nicotine dependence (FTCD), moderate risk for alcohol use disorder (AUDIT), and occasional or regular cannabis use. Readiness to quit cigarette smoking in the next 30 days (33.5%) was positively associated with age (p = .021), NRT use in the past 30 days (p = .037) and perceived importance to also reduce alcohol use (p = .033). CONCLUSIONS Findings indicate that readiness to quit cigarette smoking among young adults who drink is positively associated with importance to reduce alcohol use, but not with use patterns or levels of dependence. Interventions addressing polysubstance use may be better suited to help young adults reduce or quit cigarette smoking once they signal readiness for behavior change.
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Affiliation(s)
- Larissa J Maier
- Department of Psychiatry and Weill Institute for Neurosciences, University of California, San Francisco, CA, United States; Early Postdoc. Mobility Grantee (P2ZHP1_174812), Swiss National Science Foundation, Bern, Switzerland.
| | - Danielle E Ramo
- Department of Psychiatry and Weill Institute for Neurosciences, University of California, San Francisco, CA, United States.
| | - Manpreet Kaur
- Department of Psychiatry and Weill Institute for Neurosciences, University of California, San Francisco, CA, United States.
| | - Meredith C Meacham
- Department of Psychiatry and Weill Institute for Neurosciences, University of California, San Francisco, CA, United States.
| | - Derek D Satre
- Department of Psychiatry and Weill Institute for Neurosciences, University of California, San Francisco, CA, United States; Kaiser Permanente Northern California, Division of Research, Oakland, CA, United States.
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Kale D, Pickering A, Cooper A. Examining the relationship between impulsivity-related personality traits and e-cigarette use in adults. Addict Behav 2020; 106:106348. [PMID: 32087475 DOI: 10.1016/j.addbeh.2020.106348] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 02/05/2020] [Accepted: 02/06/2020] [Indexed: 01/08/2023]
Abstract
AIMS The present study aimed to investigate the relationship between impulsivity-related personality traits based on the UPPS-P model and e-cigarette use. The study used a sample of mainly European adults and compared e-cigarette users with non-smokers, cigarette smokers and dual users (those who currently smoke cigarettes and use e-cigarettes). Additionally, the relationship between impulsivity-related traits and frequency and intensity of e-cigarette use was examined, while the main reasons for e-cigarette use were also assessed. METHODS Participants were 720 adults (234 non-smokers, 164 smokers, 150 e-cigarette users, 172 dual users), who completed online questionnaires regarding sociodemographics, smoking/e-cigarette use behaviour, and impulsivity (UPPS-P scale). RESULTS Impulsivity-related traits did not significantly differentiate e-cigarette users from non-smokers. E-cigarette users showed lower levels of lack of perseverance than cigarette smokers, and they exhibited lower levels of negative and positive urgency than dual users. Negative urgency also significantly differentiated smokers and non-smokers, with smokers having higher levels of the trait. No significant results were found examining the relationship between the impulsivity-related traits and e-cigarette behaviour (number of days vaping per month, number of times vaping per day, and millilitres of e-liquid used per day). The main reason given for e-cigarette use was the perception that it is less harmful than cigarettes. CONCLUSION The present study found that trait impulsivity differentiated e-cigarette users from cigarette smokers and dual users, but did not differentiate e-cigarette users from non-smokers. Such findings are important to not only help us identify factors associated with e-cigarette use, but also to potentially inform treatment plans and decisions.
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Affiliation(s)
- Dimitra Kale
- Goldsmiths, University of London, United Kingdom.
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13
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Association of e-cigarette use and smoking cessation among Canadian young adult smokers: secondary analysis of data from a randomised controlled trial. J Smok Cessat 2020. [DOI: 10.1017/jsc.2020.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
AbstractAimsThis study examined the reasons for e-cigarette (EC) use, changes in self-efficacy and association between EC use and cessation of tobacco among Canadian young adult smokers over a 6-month period.MethodsA secondary analysis was conducted using data from a randomised controlled trial (RCT) of young adult Canadian smokers. EC exposure was defined as persistent, transient and non-use of ECs at baseline and follow-up. The association between EC exposure and cessation was examined using logistic regression and adjusting for co-variates.ResultsAt 6-month follow-up, persistent EC use was associated with a lower cessation rate (13%) than transient (23%) or non-use (29%). After adjusting for covariates, non-use and transient use were associated with higher odds of cessation than persistent use (AOR = 3.23, 95% CI = 1.41–7.40, P < 0.01; AOR = 2.40, 95% CI = 1.01–5.58, P < 0.05). At 6-month follow-up, persistent users (68%) had high self-efficacy as compared to transient (15%) or non-use (12%). Top reasons for EC use included use as a quit aid (67%), perceived use as less harmful (52%) and taste (32%).ConclusionsAmong young adult Canadian smokers enrolled in a RCT of a cessation intervention, persistent and transient use of ECs was associated with a lower smoking cessation rate at 6 months.
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St. Claire AW, Schillo BA, Lien RK, Keller PA, O'Gara E, D'Silva J, Kingsbury J, Helgertz S, Kinney A, Sharma E. Changing patterns in E-cigarette use among Minnesota adults between 2014 and 2018. Prev Med Rep 2020; 16:101014. [PMID: 31890471 PMCID: PMC6931229 DOI: 10.1016/j.pmedr.2019.101014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 10/04/2019] [Accepted: 10/20/2019] [Indexed: 11/30/2022] Open
Abstract
Minnesota has observed declining combustible tobacco use and a large increase in e-cigarette use among youth and young adults. Less is known about adult e-cigarette users' frequency of use, smoking status, use of flavors, and demographic differences. The Minnesota Adult Tobacco Survey (MATS) is a cross-sectional, random digit-dial telephone survey representative of Minnesotans aged 18 and over. MATS measured e-cigarette use in 2014 (N = 9304) and 2018 (N = 6065). In 2018, 6.0% of adult Minnesotans used an e-cigarette in the past 30 days; this was unchanged from 2014 (5.9%). While past 30-day e-cigarette use declined for current smokers (2014: 27.3%; 2018: 16.1% p < 0.001), it increased for never smokers (2014: 1.2%; 2018: 4.4% p < 0.001) and 18-24-year-olds (2014: 12.8%; 2018: 21.9% p = 0.001). Daily e-cigarette use increased from 2014 to 2018 for current smokers (p = 0.001), 25-44-year-olds (p < 0.001), females (p = 0.001), and those with a high-school education (p = 0.006). Among e-cigarette users in 2018, use of flavored e-cigarettes was associated with smoking status (p = 0.041), age (p < 0.001), and using e-cigarettes to quit smoking (p = 0.011). E-cigarettes appeal primarily to younger adults. Of concern are increases in never smokers initiating e-cigarette use, increasing their exposure to nicotine, addiction, and the risk of future combustible tobacco use. Simultaneously, fewer smokers are using e-cigarettes but those who do are using them more frequently. Use of flavored e-cigarettes was common and correlated with interest in quitting combustible cigarettes. These findings can inform recent calls for additional tobacco control policy and programs aimed at reducing e-cigarette use.
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Affiliation(s)
- Ann W. St. Claire
- ClearWay Minnesota, 8011 34th Ave South, Suite 400, Minneapolis, MN 55425, USA
- Corresponding author.
| | - Barbara A. Schillo
- Truth Initiative Schroeder Institute, 900 G Street, NW, Washington, DC 20001, USA
| | | | - Paula A. Keller
- ClearWay Minnesota, 8011 34th Ave South, Suite 400, Minneapolis, MN 55425, USA
| | - Erin O'Gara
- ClearWay Minnesota, 8011 34th Ave South, Suite 400, Minneapolis, MN 55425, USA
| | - Joanne D'Silva
- ClearWay Minnesota, 8011 34th Ave South, Suite 400, Minneapolis, MN 55425, USA
| | - John Kingsbury
- Minnesota Department of Health, PO Box 64882, St. Paul, MN 55164, USA
| | | | - Ann Kinney
- Minnesota Department of Health, PO Box 64882, St. Paul, MN 55164, USA
| | - Eva Sharma
- Westat, Inc., 1600 Research Boulevard, Rockville, MD 20850, USA
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Trivers KF, Gentzke AS, Phillips E, Tynan M, Marynak KL, Schauer GL. Substances used in electronic vapor products among adults in the United States, 2017. Addict Behav Rep 2019; 10:100222. [PMID: 31828201 PMCID: PMC6888746 DOI: 10.1016/j.abrep.2019.100222] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 09/20/2019] [Accepted: 09/20/2019] [Indexed: 12/31/2022] Open
Abstract
Electronic vapor products are used by adults for a variety of substances. Nicotine was the most commonly reported substance used in electronic vapor products. Many adults also use these devices for flavors and marijuana. Adults younger than 30 years and females were more likely to report flavor use.
Introduction Electronic vapor products (EVPs), including e-cigarettes, can be used to aerosolize many substances. Examination of substances used in EVPs by US adults has been limited; we assessed past-year use of EVPs to deliver various substances. Methods Data came from the 2017 SummerStyles Survey, a web-based survey of US adults (N = 4107). Ever EVP users were asked if they had used nicotine, marijuana, flavors or “something else” in an EVP during the past year. Weighted estimates for any, exclusive, and combined EVP substance use were calculated among ever (n = 586) and current (past 30-day; n = 121) EVP users. Results Past-year use of nicotine, flavors, and marijuana in EVPs was 30.7%, 23.6%, and 12.5% among ever EVP users, respectively; and 72.3%, 54.6%, and 17.8% among current EVP users. Among ever EVP users, the most commonly used substances were nicotine only (29.6%), nicotine plus flavors (27.2%), flavors only (16.4%), and marijuana only (14.9%). Among current EVP users, the most common substances used were nicotine plus flavors (39.1%), nicotine only (29.6%), and flavors only (11.2%). Among ever users, males and 18–29 year olds were more likely to report use of flavors than females and respondents ≥30 years. Conclusions Approximately 7 in 10 current EVP users reported nicotine use, about 1 in 2 used flavors, and nearly 1 in 6 used marijuana. These findings suggest that EVPs are used to consume a variety of substances and could guide efforts to address tobacco and non-tobacco substance use.
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Affiliation(s)
- Katrina F Trivers
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, GA, United States
| | - Andrea S Gentzke
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, GA, United States
| | - Elyse Phillips
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, GA, United States
| | - Michael Tynan
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, GA, United States
| | - Kristy L Marynak
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, GA, United States
| | - Gillian L Schauer
- Department of Health Services, School of Public Health, University of Washington, Seattle, WA, United States.,McKing Consulting, Atlanta, GA, United States
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