Pilot Ecological Momentary Assessment Study of Subjective and Contextual Factors Surrounding E-Cigarette and Combustible Tobacco Product Use among Young Adults

Deepa R Camenga, Angela M Haeny, Suchitra Krishnan-Sarin, Stephanie S O'Malley, Krysten W Bold, Deepa R Camenga, Angela M Haeny, Suchitra Krishnan-Sarin, Stephanie S O'Malley, Krysten W Bold

Abstract

Background: Dual use of e-cigarettes and combustible tobacco products is common in young adults. We aimed to explore how ratings of subjective and contextual factors differed between discrete episodes of e-cigarette use vs. combustible tobacco product smoking among a sample of young adults.

Methods: Young adults (N = 29, ages 18-30) who used e-cigarettes and ≥1 combustible tobacco product at least once weekly completed a 1-week smartphone-based ecological momentary assessment (EMA). Twice daily random prompts assessed past-15-min use of tobacco products, ratings of subjective factors (e.g., negative affect, craving), and contextual factors related to activity, location, and companionship. A multivariable GEE model assessed whether subjective or contextual factors were associated with e-cigarette vs. combustible tobacco product episodes.

Results: 184 tobacco use episodes were reported (39.7% e-cigarette, 60.3% combustible tobacco product). High baseline cigarette dependence, as measured by the Fagerström Test for Cigarette Dependence, was associated with lower odds of e-cigarette vs. combustible tobacco product episodes (aOR 0.01, 95% CI (0.002-0.08); p < 0.001). Neither between- or within-subjects negative affect or craving scores were associated with e-cigarette use. Activities of eating/drinking (aOR 0.20, 95% CI (0.08-0.49); p = 0.001) and being in the companionship of a person who smoked cigarettes (aOR 0.13, 95% CI (0.04-0.43); p = 0.001) were associated with lower odds of e-cigarette vs. combustible tobacco product use episodes. However, traveling (aOR 12.02, 95% CI (3.77-38.26); p ≤ 0.001) and being in a public space (aOR 2.76, 95% CI (1.10-6.96); p = 0.03) were associated with higher odds of e-cigarette than combustible tobacco product use episodes.

Conclusions: This pilot data suggests that unique contextual factors may be associated with e-cigarette use, compared to combustible tobacco smoking in a sample of young adults who use both e-cigarettes and combustible tobacco products. Future research with larger samples is needed to better characterize varying contexts and cues for tobacco use among young adults who are dual users.

Keywords: e-cigarette; tobacco; young adult.

Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH or FDA.

References

    1. Stanton C.A., Sharma E., Edwards K.C., Halenar M.J., Taylor K.A., Kasza K.A., Day H., Anic G., Gardner L.D., Hammad H.T., et al. Longitudinal transitions of exclusive and polytobacco electronic nicotine delivery systems (ENDS) use among youth, young adults and adults in the USA: Findings from the PATH Study Waves 1–3 (2013–2016) Tobacco Control. 2020;29((Suppl. S3)):s147–s154. doi: 10.1136/tobaccocontrol-2019-055574.
    1. Hartmann-Boyce J., McRobbie H., Lindson N., Bullen C., Begh R., Theodoulou A., Notley C., Rigotti N.A., Turner T., Butler A.R., et al. Electronic cigarettes for smoking cessation. Cochrane Database Syst. Rev. 2021 doi: 10.1002/14651858.CD010216.pub5.
    1. Harlow A.F., Fetterman J.L., Ross C.S., Robertson R.M., Bhatnagar A., Benjamin E.J., Stokes A.C. Association of device type, flavours and vaping behaviour with tobacco product transitions among adult electronic cigarette users in the USA. Tob Control. 2021 doi: 10.1136/tobaccocontrol-2020-055999.
    1. Shiyko M., Naab P., Shiffman S., Li R. Modeling complexity of EMA data: Time-varying lagged effects of negative affect on smoking urges for subgroups of nicotine addiction. Nicotine Tob Res. 2014;16((Suppl. S2)):S144–S150. doi: 10.1093/ntr/ntt109.
    1. Shiffman S., Scholl S.M., Mao J., Ferguson S.G., Hedeker D., Tindle H.A. Ecological momentary assessment of temptations and lapses in non-daily smokers. Psychopharmacology. 2020;237:2353–2365. doi: 10.1007/s00213-020-05539-3.
    1. Myers M.G., Gwaltney C.J., Strong D.R., Ramsey S.E., Brown R.A., Monti P.M., Colby S.M. Adolescent First Lapse Following Smoking Cessation: Situation Characteristics, Precipitants and Proximal Influences. Addict. Behav. 2011;36:1253–1260. doi: 10.1016/j.addbeh.2011.07.040.
    1. Huh J., Cerrada C.J., Kirkpatrick M.G., Dunton G., Leventhal A.M. Social contexts of momentary craving to smoke among Korean American emerging adults. Addict. Behav. 2016;56:23–29. doi: 10.1016/j.addbeh.2016.01.006.
    1. Stone A.A., Shiffman S. Ecological momentary assessment (EMA) in behavorial medicine. Ann. Behav. Med. 1994;16:199–202. doi: 10.1093/abm/16.3.199.
    1. Shiffman S., Hufford M., Hickcox M., Paty J.A., Gnys M., Kassel J.D. Remember that? A comparison of real-time versus retrospective recall of smoking lapses. J. Consult. Clin. Psychol. 1997;65:292–300. doi: 10.1037/0022-006X.65.2.292.a.
    1. Cooper M.R., Case K.R., Hebert E.T., Vandewater E.A., Raese K.A., Perry C.L., Businelle M.S. Characterizing ENDS use in young adults with ecological momentary assessment: Results from a pilot study. Addict. Behav. 2018;91:30–36. doi: 10.1016/j.addbeh.2018.11.024.
    1. Berg C.J., Haardorfer R., Payne J.B., Getachew B., Vu M., Guttentag A., Kirchner T.R. Ecological momentary assessment of various tobacco product use among young adults. Addict. Behav. 2019;92:38–46. doi: 10.1016/j.addbeh.2018.12.014.
    1. MetricWire: Breakthrough Research. [(accessed on 14 October 2021)]. Available online:
    1. Brown R.A., Burgess E.S., Sales S.D., Whiteley J.A., Evans D.M., Miller I.W. Reliability and validity of a smoking timeline follow-back interview. Psychol. Addict. Behav. 1998;12:101–112. doi: 10.1037/0893-164X.12.2.101.
    1. Robinson S.M., Sobell L.C., Sobell M.B., Leo G.I. Reliability of the Timeline Followback for cocaine, cannabis, and cigarette use. Psychol. Addict. Behav. J. Soc. Psychol. Addict. Behav. 2014;28:154–162. doi: 10.1037/a0030992.
    1. Sobell L., Sobell M., Buchan G., Cleland P., Fedoroff I., Leo G., Sobell L.C., Sobell M.B. The reliability of the Timeline Followback method applied to drug, cigarette, and cannabis use; Proceedings of the the 30th Annual Meeting of the Association for Advancement of Behavior Therapy; New York, NY, USA. 5 November 1996.
    1. Heatherton T.F., Kozlowski L.T., Frecker R.C., Fagerstrom K.-O. The Fagerström Test for Nicotine Dependence: A revision of the Fagerstrom Tolerance Questionnaire. Br. J. Addict. 1991;86:1119–1127. doi: 10.1111/j.1360-0443.1991.tb01879.x.
    1. Thompson E.R. Development and Validation of an Internationally Reliable Short-Form of the Positive and Negative Affect Schedule (PANAS) J. Cross-Cult. Psychol. 2007;38:227–242. doi: 10.1177/0022022106297301.
    1. West R., Hajek P. Evaluation of the mood and physical symptoms scale (MPSS) to assess cigarette withdrawal. Psychopharmacology. 2004;177:195–199. doi: 10.1007/s00213-004-1923-6.
    1. Hosmer D.W. Applied Logistic Regression. 3rd ed. Volume 398 Wiley; Hoboken, NJ, USA: 2013.
    1. Berg C.J., Krishnan N., Graham A.L., Abroms L.C. A synthesis of the literature to inform vaping cessation interventions for young adults. Addict. Behav. 2021;119:106898. doi: 10.1016/j.addbeh.2021.106898.
    1. Sanchez S., Kaufman P., Pelletier H., Baskerville B., Feng P., O’Connor S., Schwartz R., Chaiton M. Is vaping cessation like smoking cessation? A qualitative study exploring the responses of youth and young adults who vape e-cigarettes. Addict. Behav. 2021;113:106687. doi: 10.1016/j.addbeh.2020.106687.
    1. Kinouani S., Leflot C., Vanderkam P., Auriacombe M., Langlois E., Tzourio C. Motivations for using electronic cigarettes in young adults: A systematic review. Substance. Abuse. 2020;41:315–322. doi: 10.1080/08897077.2019.1671937.
    1. Levy D.T., Tam J., Kuo C., Fong G.T., Chaloupka F. The Impact of Implementing Tobacco Control Policies: The 2017 Tobacco Control Policy Scorecard. J. Public Health Manag. Pract. 2018;24:448–457. doi: 10.1097/PHH.0000000000000780.
    1. Du Y., Liu B., Xu G., Rong S., Sun Y., Wu Y., Snetselaar L.G., Wallace R.B., Bao W. Association of Electronic Cigarette Regulations With Electronic Cigarette Use Among Adults in the United States. JAMA Netw. Open. 2020;3:e1920255. doi: 10.1001/jamanetworkopen.2019.20255.
    1. Shiffman S., Gwaltney C.J., Balabanis M.H., Liu K.S., Paty J.A., Kassel J.D., Hickcox M., Gnys M. Immediate antecedents of cigarette smoking: An analysis from ecological momentary assessment. J. Abnorm. Psychol. 2002;111:531–545. doi: 10.1037/0021-843X.111.4.531.
    1. Shiffman S., Dunbar M.S., Li X., Scholl S.M., Tindle H.A., Anderson S.J., Ferguson S.G. Smoking patterns and stimulus control in intermittent and daily smokers. PLoS ONE. 2014;9:e89911. doi: 10.1371/journal.pone.0089911.
    1. Thrul J., Gubner N.R., Tice C.L., Lisha N.E., Ling P.M. Young adults report increased pleasure from using e-cigarettes and smoking tobacco cigarettes when drinking alcohol. Addict. Behav. 2019;93:135–140. doi: 10.1016/j.addbeh.2019.01.011.
    1. King A.C., Smith L.J., McNamara P.J., Matthews A.K., Fridberg D.J. Passive exposure to electronic cigarette (e-cigarette) use increases desire for combustible and e-cigarettes in young adult smokers. Tob Control. 2015;24:501–504. doi: 10.1136/tobaccocontrol-2014-051563.
    1. King A.C., Smith L.J., Fridberg D.J., Matthews A.K., McNamara P.J., Cao D. Exposure to electronic nicotine delivery systems (ENDS) visual imagery increases smoking urge and desire. Psychol. Addict. Behav. J. Soc. Psychol. Addict. Behav. 2016;30:106–112. doi: 10.1037/adb0000123.
    1. King A.C., Smith L.J., McNamara P.J., Cao D. Second Generation Electronic Nicotine Delivery System Vape Pen Exposure Generalizes as a Smoking Cue. Nicotine Tob Res. 2018;20:246–252. doi: 10.1093/ntr/ntw327.
    1. Song A.V., Ling P.M. Social smoking among young adults: Investigation of intentions and attempts to quit. Am. J. Public Health. 2011;101:1291–1296. doi: 10.2105/AJPH.2010.300012.
    1. Villanti A.C., Johnson A.L., Rath J.M., Williams V., Vallone D.M., Abrams D.B., Hedeker D., Mermelstein R.J. Identifying “social smoking” U.S. young adults using an empirically-driven approach. Addict. Behav. 2017;70:83–89. doi: 10.1016/j.addbeh.2017.02.004.
    1. Buu A., Cai Z., Li R., Wong S.W., Lin H.C., Su W.C., Jorenby D.E., Piper M.E. The association between short-term emotion dynamics and cigarette dependence: A comprehensive examination of dynamic measures. Drug Alcohol Depend. 2021;218:108341. doi: 10.1016/j.drugalcdep.2020.108341.
    1. Okunna N. A Comparison of Mental and Behavioral Health Risks Factors Associated with Current Dual Use of Electronic Cigarette and Conventional Tobacco Cigarettes with Exclusive Tobacco Cigarette Use and Nonuse among Adults in the United States. Am. J. Addict. 2021;30:138–146. doi: 10.1111/ajad.13110.

Source: PubMed

Sponsorer og samarbeidspartnere

Medisinsk tilstand

Legemiddelintervensjoner

3
Abonnere