A longitudinal study of the association between e-cigarette use contexts and alcohol use problems among college students.

Objective: Previous studies had explored the associations between e-cigarette use and alcohol use problems, yet they did not fully consider e-cigarette use contexts. This longitudinal study conducted a prospective examination of e-cigarette use contexts and alcohol use problems among college students. Participants: College e-cigarette users at three public universities from Fall 2019 to Fall 2020 were included (N = 377). Methods: A linear mixed model with a random intercept and random slope was employed to examine the longitudinal associations. Results: Higher frequencies of e-cigarette use (β = 0.38, p < 0.001), being hooked on e-cigarettes (β = 0.96, p < 0.01), using e-cigarettes for socializing purposes (β = 0.58, p < 0.05), and more occasions of co-using e-cigarettes with alcohol (β = 0.05, p < 0.001) were linked to more alcohol use problems. Conclusions: Intervention efforts should incorporate comprehensive screening that includes both e-cigarette and alcohol use, enhance awareness of peer influence, and provide at-risk populations with education regarding the potential synergistic effects of e-cigarette and alcohol co-use.