Feasibility of and reactivity to ecological momentary assessment (EMA) during electronic cigarette use initiation in adults who smoke daily

Background and objectives

This pilot study tested the feasibility of tracking e-cigarette initiation over three months using a burst-of-measurement approach and examined reactivity to the ecological momentary assessment (EMA) data capture technique in this context.

Methods

Adults who smoked daily and were interested in trying e-cigarette use received an e-cigarette starter kit and were randomized to complete EMA reports (n = 30) vs. not (n = 29). Participants (M_age=44.1 years [SD=12.6], 61.0 % male, 54.3 % White, 38.9 % Black/African American) smoked 13.0 cigarettes per day on average (SD=8.4) and reported mild-to-moderate nicotine dependence (M_FTND=4.0 [SD=2.3]). Biochemical assessment and surveys were conducted at enrollment, e-cigarette initiation (1 week later), and 1-week, 1-month, and 3-month post e-cigarette initiation.

Results

A subset (17 %) of participants did not achieve the minimum 75 % EMA adherence at Week 1. The remaining participants showed excellent adherence with the EMA protocol, with a consistently high response rate to audibly prompted mini-surveys during screening (93 %) and follow-up weeks (93 %, 93 %, and 92 %, respectively). No consistent trend emerged in comparing the two randomized groups, either on variables relevant to the public health impact of e-cigarette initiation (i.e., cigarettes/day, exposure to smoke, exposure to nicotine, motivation to quit smoking), or in e-cigarette use (i.e., bouts/day, puffs/bout), with average Cohen's d values across timepoints ranging from d = 0.02 for exposure to smoke to d = 0.06 for cigarettes per day.

Conclusions

Conducting EMA with adults who smoke daily and are initiating e-cigarette use appears feasible, with some caveats. Reactivity to EMA during e-cigarette initiation appears to be small or non-significant.