Understanding the motivational mechanisms for smoking and vaping among dual users and exclusive smokers

Background

Understanding the motivational processes that influence e-cigarette use in a laboratory setting may help elucidate mechanisms that support long-term ecigarette use, which could have significant clinical and public health consequences.

Methods

Secondary analyses were conducted on data from exclusive smokers (N=47) and dual users (N=88) who underwent a laboratory ad lib use session. Participants were given 10 minutes to smoke (exclusive smokers) or vape (dual users) as much as they wanted. Withdrawal was assessed pre- and post-use. Smoking and vaping behavior was coded from session videos. Person-level predictors included cigarette/ecigarette craving-relief expectancies, demographics, and cigarette/e-cigarette use and dependence. Smoking and vaping status was assessed at Year 1 using self-reported 30-day point prevalence. Data were analyzed using general linear models and logistic regressions.

Results

Both groups reported reductions in withdrawal after product use, including cigarette craving. Baseline e-cigarette craving-relief expectancies, pre-session ecigarette craving, heaviness of e-cigarette use, and relative e-cigarette dependence were significant univariate predictors of continued vaping in dual users at Year 1 (ORs>1.04, ps<.05). Dual users and exclusive smokers did not differ on use behavior (i.e., average number of puffs, ps>.16).

Conclusions

E-cigarette use alleviated withdrawal, including cigarette and e-cigarette craving, in dual users. Laboratory use behavior did not differ between dual users using e-cigarettes and exclusive smokers using cigarettes. Greater e-cigarette craving-relief expectancies, e-cigarette craving, heaviness of e-cigarette use, and morning product use pattern (‘relative dependence’) may reflect mechanisms that sustain e-cigarette use.