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Vaping characteristics and expectancies are associated with smoking cessation propensity among dual users of combustible and electronic cigarettes.
Addiction. 2019 May; 114(5):896-906.A

Abstract

BACKGROUND AND AIMS

Most e-cigarette users who also smoke combustible cigarettes (dual users) begin vaping to quit smoking, yet only a subset succeeds. We hypothesized that reinforcing characteristics of e-cigarettes (vaping reinforcement) would positively predict smoking cessation propensity (SCP) among dual users.

DESIGN

Secondary analysis of cross-sectional baseline data from dual users in an ongoing smoking cessation trial. Exploratory and confirmatory factor analysis (EFA and CFA) created latent variables for vaping reinforcement and SCP. A structural equation modeling (SEM) approach was used to test the hypothesis.

SETTING

United States.

PARTICIPANTS

A national sample of dual users of combustible and electronic cigarettes who smoke and vape at least once per week (n = 2896) were enrolled (63% male; mean age = 29.9 years) into a randomized controlled trial in which they would receive either smoking cessation materials or no smoking cessation materials.

MEASUREMENTS

Vaping reinforcement was indexed by vaping frequency (days/week vaping, times/day vaping, puffs/e-cigarette use), e-cigarette characteristics [numbers of modifications and tobacco or non-tobacco flavors, nicotine content (mg) and positive e-cigarette expectancies]. SCP was measured by items of confidence, commitment to being smoke-free, cessation motivation (contemplation ladder), change in cigarettes per day since beginning e-cigarette use and negative smoking expectancies.

FINDINGS

Four factors emerged from the EFA: vaping propensity (vaping frequency, positive expectancies), vaping enthusiasm (e-cigarette modifications, using non-tobacco flavors, puffs per use), nicotine/tobacco flavor (nicotine strength, tobacco flavors) and SCP (negative expectancies about smoking, motivation to quit smoking, reduction in smoking). A CFA upheld the exploratory factor structure [root mean square error of approximation (RMSEA) = 0.046, CFI = 0.91]. An SEM with the three vaping latent variables directly predicting SCP had good model fit (RMSEA = 0.030, CFI = 0.97) with a positive relationship of vaping propensity (0.509, P < 0.001), and small negative relationships of vaping enthusiasm (-0.158, P = 0.014) and nicotine/tobacco flavor (-0.230, P < 0.001).

CONCLUSIONS

Among e-cigarette users who also smoke combustible cigarettes, frequent vaping combined with positive e-cigarette expectancies appears to predict greater smoking cessation propensity. However, vaping enthusiasm (measured by e-cigarette modifications, using non-tobacco flavors and puffs per use), higher nicotine content and use of tobacco flavored solution may reduce cessation propensity.

Authors+Show Affiliations

Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, FL, USA.Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, FL, USA. Department of Psychology, University of South Florida, Tampa, FL, USA. Department of Oncologic Sciences, University of South Florida, Tampa, FL, USA.Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, FL, USA.Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, FL, USA. Department of Psychology, University of South Florida, Tampa, FL, USA. Department of Oncologic Sciences, University of South Florida, Tampa, FL, USA.Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, FL, USA.Department of Psychology, University of South Florida, Tampa, FL, USA. Department of Oncologic Sciences, University of South Florida, Tampa, FL, USA. Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center, Tampa, FL, USA.Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, FL, USA. Department of Psychology, University of South Florida, Tampa, FL, USA.School of Population Health, Faculty of Medical and Health Science, University of Auckland, New Zealand.Department of Pediatrics, Eastern Virginia Medical School, Norfolk, VA, USA.Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, FL, USA. Department of Psychology, University of South Florida, Tampa, FL, USA. Department of Oncologic Sciences, University of South Florida, Tampa, FL, USA.

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

30644627

Citation

Brandon, Karen O., et al. "Vaping Characteristics and Expectancies Are Associated With Smoking Cessation Propensity Among Dual Users of Combustible and Electronic Cigarettes." Addiction (Abingdon, England), vol. 114, no. 5, 2019, pp. 896-906.
Brandon KO, Simmons VN, Meltzer LR, et al. Vaping characteristics and expectancies are associated with smoking cessation propensity among dual users of combustible and electronic cigarettes. Addiction. 2019;114(5):896-906.
Brandon, K. O., Simmons, V. N., Meltzer, L. R., Drobes, D. J., Martínez, Ú., Sutton, S. K., Palmer, A. M., Bullen, C. R., Harrell, P. T., & Brandon, T. H. (2019). Vaping characteristics and expectancies are associated with smoking cessation propensity among dual users of combustible and electronic cigarettes. Addiction (Abingdon, England), 114(5), 896-906. https://doi.org/10.1111/add.14551
Brandon KO, et al. Vaping Characteristics and Expectancies Are Associated With Smoking Cessation Propensity Among Dual Users of Combustible and Electronic Cigarettes. Addiction. 2019;114(5):896-906. PubMed PMID: 30644627.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Vaping characteristics and expectancies are associated with smoking cessation propensity among dual users of combustible and electronic cigarettes. AU - Brandon,Karen O, AU - Simmons,Vani N, AU - Meltzer,Lauren R, AU - Drobes,David J, AU - Martínez,Úrsula, AU - Sutton,Steven K, AU - Palmer,Amanda M, AU - Bullen,Christopher R, AU - Harrell,Paul T, AU - Brandon,Thomas H, Y1 - 2019/02/13/ PY - 2018/9/18/received PY - 2018/11/21/revised PY - 2019/1/4/accepted PY - 2019/1/16/pubmed PY - 2020/6/17/medline PY - 2019/1/16/entrez KW - Dual-use KW - e-cigarettes KW - latent variable KW - smoking KW - smoking cessation KW - structural equation modeling SP - 896 EP - 906 JF - Addiction (Abingdon, England) JO - Addiction VL - 114 IS - 5 N2 - BACKGROUND AND AIMS: Most e-cigarette users who also smoke combustible cigarettes (dual users) begin vaping to quit smoking, yet only a subset succeeds. We hypothesized that reinforcing characteristics of e-cigarettes (vaping reinforcement) would positively predict smoking cessation propensity (SCP) among dual users. DESIGN: Secondary analysis of cross-sectional baseline data from dual users in an ongoing smoking cessation trial. Exploratory and confirmatory factor analysis (EFA and CFA) created latent variables for vaping reinforcement and SCP. A structural equation modeling (SEM) approach was used to test the hypothesis. SETTING: United States. PARTICIPANTS: A national sample of dual users of combustible and electronic cigarettes who smoke and vape at least once per week (n = 2896) were enrolled (63% male; mean age = 29.9 years) into a randomized controlled trial in which they would receive either smoking cessation materials or no smoking cessation materials. MEASUREMENTS: Vaping reinforcement was indexed by vaping frequency (days/week vaping, times/day vaping, puffs/e-cigarette use), e-cigarette characteristics [numbers of modifications and tobacco or non-tobacco flavors, nicotine content (mg) and positive e-cigarette expectancies]. SCP was measured by items of confidence, commitment to being smoke-free, cessation motivation (contemplation ladder), change in cigarettes per day since beginning e-cigarette use and negative smoking expectancies. FINDINGS: Four factors emerged from the EFA: vaping propensity (vaping frequency, positive expectancies), vaping enthusiasm (e-cigarette modifications, using non-tobacco flavors, puffs per use), nicotine/tobacco flavor (nicotine strength, tobacco flavors) and SCP (negative expectancies about smoking, motivation to quit smoking, reduction in smoking). A CFA upheld the exploratory factor structure [root mean square error of approximation (RMSEA) = 0.046, CFI = 0.91]. An SEM with the three vaping latent variables directly predicting SCP had good model fit (RMSEA = 0.030, CFI = 0.97) with a positive relationship of vaping propensity (0.509, P < 0.001), and small negative relationships of vaping enthusiasm (-0.158, P = 0.014) and nicotine/tobacco flavor (-0.230, P < 0.001). CONCLUSIONS: Among e-cigarette users who also smoke combustible cigarettes, frequent vaping combined with positive e-cigarette expectancies appears to predict greater smoking cessation propensity. However, vaping enthusiasm (measured by e-cigarette modifications, using non-tobacco flavors and puffs per use), higher nicotine content and use of tobacco flavored solution may reduce cessation propensity. SN - 1360-0443 UR - https://www.unboundmedicine.com/medline/citation/30644627/Vaping_characteristics_and_expectancies_are_associated_with_smoking_cessation_propensity_among_dual_users_of_combustible_and_electronic_cigarettes_ DB - PRIME DP - Unbound Medicine ER -