Exposure to electronic nicotine delivery systems (ENDS) visual imagery increases smoking urge and desire

Abstract

Use and awareness of electronic nicotine delivery systems (ENDS; also known as electronic cigarettes or e-cigarettes) has increased rapidly in recent years, particularly among young adults. As use of ENDS resembles traditional smoking in both hand-to-mouth movements and inhalation and exhalation behaviors, we determined whether exposure to e-cigarette use via video exposure would act as a cue to elicit urge and desire for a combustible cigarette. Young adult smokers (mean age of 26.3 ± 4.1 years) were randomized to view a brief video montage of advertisements depicting either e-cigarette vaping (n = 38) or bottled water drinking (n = 40). Pre- and postcue exposure assessments were conducted in a controlled laboratory setting without other smoking or vaping cues present or behaviors allowed. Primary outcomes included change from pre-exposure baseline in smoking urge (Brief Questionnaire of Smoking Urges) and desire for a combustible and e-cigarette (visual analogue scales). Results showed that relative to exposure to the bottled water video, exposure to the ENDS video significantly increased smoking urge (p < .001) as well as desire for a regular cigarette (p < .05) and an e-cigarette (p < .001). These findings provide preliminary evidence that passive exposure to video imagery of ENDS use may generalize as a condition cue and evoke urges for a combustible cigarette in young adult smokers. It remains to be determined whether such increases in urge and desire correspond to increases in actual smoking behavior.

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Figures

Figure 1

Cue response values are mean (±SEM) change scores from baseline to 5 and 15 minutes post onset of each video cue. Visual analogue scale (VAS) ratings on desire for water (A), desire for an e-cigarette (B), Brief Questionnaire of Smoking Urges (BQSU) total score (C), and desire for a regular cigarette (D). VAS scored on a 0–100 scale anchored from ‘not at all’ to ‘most ever’ and BQSU scored on a 10 point scale. Participants were randomised to either the ENDS cue group (n=38) or the water cue group (n=40). Statistical analyses were from Generalized Estimating Equations.