scholarly journals Characterizing symptoms of e-cigarette dependence: a qualitative study of young adults

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kelsey A. Simpson ◽  
Afton Kechter ◽  
Sara J. Schiff ◽  
Jessica L. Braymiller ◽  
Naosuke Yamaguchi ◽  
...  
Keyword(s):  
Young Adults ◽  
Nicotine Dependence ◽  
Thematic Analysis ◽  
Qualitative Interviews ◽  
Cigarette Use ◽  
Limited Data ◽  
Use Patterns ◽  
Quit Attempts ◽  
Nicotine Consumption ◽  
Cigarette Dependence

Abstract Background While rates of e-cigarette use (‘vaping’) continue to potentiate concern, there is limited data on common symptoms of e-cigarette dependence among young adults who vape. This study sought to critically explore how young adults experience, manifest, and conceptualize vaping dependence symptoms in their everyday lives. Methods Between June 2018 and 2019, in-depth qualitative interviews were conducted with 62 young adults who use e-cigarettes (aged 18–25) and live in Southern California. We explored participants’ product preferences, daily e-cigarette use patterns, vaping history, withdrawal experiences, and quit attempts or periods of cessation. We used a thematic analysis approach to interpret the transcripts. Results Young adults discussed nine dimensions of vaping dependence that were organized into two categories: 1) general nicotine dependence symptoms, and 2) unique dependence symptoms related to vaping. Nicotine dependence symptoms included cravings and urgency to use, increased use to achieve desired effects, and unsuccessful quit attempts and withdrawal. Symptoms unique to vaping dependence included greater nicotine consumption due to accessibility and lack of restrictions, habitual vaping, inability to track vaping frequency, immediate gratification and comfort, social acceptability and norms, and awareness of vaping dependency. Conclusions In addition to nicotine dependence symptoms that have been characterized for other tobacco products, young adult e-cigarette users described unique symptoms of vaping dependence that necessitate the need for more refined measures. All dimensions of vaping dependence should be considered in discussions of policies as well as treatment and education efforts intended to protect young people from e-cigarette dependence.

scholarly journals Psychometric Evaluation of the E-cigarette Dependence Scale

2018 ◽  
Vol 21 (11) ◽  
pp. 1556-1564 ◽  
Author(s):  
Meghan E Morean ◽  
Suchitra Krishnan-Sarin ◽  
Steve Sussman ◽  
Jonathan Foulds ◽  
Howard Fishbein ◽  
...  
Keyword(s):  
Nicotine Dependence ◽  
Convergent Validity ◽  
Cigarette Use ◽  
Cigarette Smokers ◽  
Test Criterion ◽  
Scalar Invariant ◽  
Wide Range ◽  
Current Cigarette ◽  
Dependence Scale ◽  
Cigarette Dependence

Abstract Introduction Psychometrically sound measures of e-cigarette dependence are lacking. Methods We modified the PROMIS Item Bank v1.0—Smoking: Nicotine Dependence for All Smokers for use with e-cigarettes and evaluated the psychometrics of the 22-, 8-, and 4-item adapted versions, referred to as The E-cigarette dependence scale (EDS). Adults (1009) who reported using e-cigarettes at least weekly completed an anonymous survey in summer 2016 (50.2% male, 77.1% White, mean age 35.81 [10.71], 66.4% daily e-cigarette users, 72.6% current cigarette smokers). Psychometric analyses included confirmatory factor analysis, internal consistency, measurement invariance, examination of mean-level differences, convergent validity, and test-criterion relationships with e-cigarette use outcomes. Results All EDS versions had confirmable, internally consistent latent structures that were scalar invariant by sex, race, e-cigarette use (nondaily/daily), e-liquid nicotine content (no/yes), and current cigarette smoking status (no/yes). Daily e-cigarette users, nicotine e-liquid users, and cigarette smokers reported being more dependent on e-cigarettes than their counterparts. All EDS versions correlated strongly with one another, evidenced convergent validity with the Penn State E-cigarette Dependence Index and time to first e-cigarette use in the morning, and evidenced test-criterion relationships with vaping frequency, e-liquid nicotine concentration, and e-cigarette quit attempts. Similar results were observed when analyses were conducted within subsamples of exclusive e-cigarette users and duals-users of cigarettes and e-cigarettes. Conclusions Each EDS version evidenced strong psychometric properties for assessing e-cigarette dependence in adults who either use e-cigarette exclusively or who are dual-users of cigarettes and e-cigarettes. However, results indicated little benefit of the longer versions over the 4-item EDS, which provides an efficient assessment of e-cigarette dependence. Implications The availability of the novel, psychometrically sound EDS can further research on a wide range of questions related to e-cigarette use and dependence. In addition, the overlap between the EDS and the original PROMIS that was developed for assessing nicotine dependence to cigarettes provides consistency within the field.

scholarly journals Use of symptom checkers for COVID-19-related symptoms among university students: a qualitative study

2021 ◽  
pp. bmjinnov-2020-000498
Author(s):  
Stephanie Aboueid ◽  
Samantha B Meyer ◽  
James R Wallace ◽  
Shreya Mahajan ◽  
Teeyaa Nur ◽  
...  
Keyword(s):  
Young Adults ◽  
Qualitative Study ◽  
Thematic Analysis ◽  
Health Professionals ◽  
Qualitative Interviews ◽  
Healthcare Services ◽  
Healthcare Systems ◽  
Positive Experience ◽  
Perceived Credibility ◽  
Inductive Thematic Analysis

ObjectiveSymptom checkers are potentially beneficial tools during pandemics. To increase the use of the platform, perspectives of end users must be gathered. Our objectives were to understand the perspectives and experiences of young adults related to the use of symptom checkers for assessing COVID-19-related symptoms and to identify areas for improvement.MethodsWe conducted semistructured qualitative interviews with 22 young adults (18–34 years of age) at a university in Ontario, Canada. Interviews were audio-recorded, transcribed, and analysed using inductive thematic analysis.ResultsWe identified six main themes related to the decision of using a symptom checker for COVID-19 symptoms: (1) presence of symptoms or a combination of symptoms, (2) knowledge about COVID-19 symptoms, (3) fear of seeking in-person healthcare services, (4) awareness about symptom checkers, (5) paranoia and (6) curiosity. Participants who used symptom checkers shared by governmental entities reported an overall positive experience. Individuals who used non-credible sources reported suboptimal experiences due to lack of perceived credibility. Five main areas for improvement were identified: (1) information about the creators of the platform, (2) explanation of symptoms, (3) personalised experience, (4) language options, and (5) option to get tested.ConclusionsThis study suggests an increased acceptance of symptom checkers due to the perceived risks of infection associated with seeking in-person healthcare services. Symptom checkers have the potential to reduce the burden on healthcare systems and health professionals, especially during pandemics; however, these platforms could be improved to increase use.

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

2021 ◽  
Vol 18 (21) ◽  
pp. 11005
Author(s):  
Deepa R. Camenga ◽  
Angela M. Haeny ◽  
Suchitra Krishnan-Sarin ◽  
Stephanie S. O’Malley ◽  
Krysten W. Bold
Keyword(s):  
Young Adults ◽  
Ecological Momentary Assessment ◽  
Contextual Factors ◽  
Tobacco Product ◽  
Cigarette Use ◽  
Tobacco Products ◽  
Product Use ◽  
Cigarette Dependence ◽  
Ecological Momentary ◽  
Momentary Assessment

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.

scholarly journals E-Cigarettes are More Addictive than Traditional Cigarettes—A Study in Highly Educated Young People

2019 ◽  
Vol 16 (13) ◽  
pp. 2279 ◽  
Author(s):  
Jankowski ◽  
Krzystanek ◽  
Zejda ◽  
Majek ◽  
Lubanski ◽  
...  
Keyword(s):  
Young Adults ◽  
Young People ◽  
Nicotine Dependence ◽  
Healthy Adults ◽  
Cigarette Use ◽  
Cigarette Smokers ◽  
Highly Educated ◽  
Item Questionnaire ◽  
Traditional Tobacco ◽  
Addictive Potential

E-cigarettes are often considered less addictive than traditional cigarettes. This study aimed to assess patterns of e-cigarette use and to compare nicotine dependence among cigarette and e-cigarette users in a group of highly educated young adults. From 3002 healthy adults, a representative group of 30 cigarette smokers, 30 exclusive e-cigarette users, and 30 dual users were recruited. A 25-item questionnaire was used to collect information related to the patterns and attitudes towards the use of cigarettes and e-cigarettes. The Fagerström test for nicotine dependence (FTND) and its adapted version for e-cigarettes were used to analyze nicotine dependence in each of the groups. The nicotine dependence levels measured with FTND were over two times higher among e-cigarette users (mean 3.5) compared to traditional tobacco smokers (mean 1.6; p<0.001). Similarly, among dual users, nicotine dependence levels were higher when using an e-cigarette (mean 4.7) compared to using traditional cigarettes (mean 3.2; p=0.03). Habits and behaviors associated with the use of e-cigarettes did not differ significantly (p>0.05) between exclusive e-cigarette users and dual users. The findings suggest that e-cigarettes may have a higher addictive potential than smoked cigarettes among young adults.

scholarly journals Validation of an E-cigarette Purchase Task in Advanced Generation Device Users

2020 ◽  
Vol 22 (10) ◽  
pp. 1851-1859 ◽  
Author(s):  
Rachel N Cassidy ◽  
Victoria Long ◽  
Jennifer W Tidey ◽  
Suzanne M Colby
Keyword(s):  
Comparison Method ◽  
Cigarette Use ◽  
Behavioral Economic ◽  
Reinforcing Efficacy ◽  
Use Patterns ◽  
Reinforcing Value ◽  
Clinical Indices ◽  
Cigarette Dependence ◽  
Advanced Generation ◽  
Cigarette Purchase Task

Abstract Introduction Behavioral economic purchase tasks are used to estimate the reinforcing value of drugs by asking participants how much they would purchase across a range of increasing prices. We sought to validate such a task for e-cigarettes in experienced users of advanced generation, tank-style devices. Methods Dual users of cigarettes and e-cigarettes (N = 54) and exclusive e-cigarette users (N = 59) attended one session during which they completed assessments including two versions of the E-cigarette Purchase Task: one that asked how many puffs of their e-cigarette they would purchase in 24 hours at varying prices and one that asked how many mLs of e-liquid they would purchase. We correlated purchase task outcomes with other measures of e-cigarette use. We also compared the tasks across dual and exclusive users. Results Indices derived from the mLs-based task were more likely to be correlated with self-reported use rates, e-cigarette dependence, and cotinine levels than the puffs-based task. Exclusive users showed greater demand on than dual users only on the mLs version when using an F-test comparison method, while multivariate analysis of variance (MANOVA) results showed that dual users showed greater demand only on the puffs task. Conclusions Results indicate that the mLs version had greater validity than the puffs version in terms of clinical indices. Dual users may still be on a trajectory to fully switching to e-cigarettes; thus, puffs as a measure may be more intuitive, as this measure is shared by cigarettes and e-cigarettes. For exclusive users, the unit they purchase their e-liquid in may be the most relevant unit and better capture their demand for that product. Implications Behavioral economic purchase tasks have been widely used to understand nicotine use. We have developed two versions of a purchase task for e-cigarette use and compared the two versions in users of advanced generation e-cigarette devices. We found that the mLs version of the task better-reflected use patterns relative to a puffs version, which suggests that participants struggle to place monetary value on a unit of consumption (ie, puffs). Validated measures of e-cigarette reinforcement will be important as researchers and regulators determine which features of these products contribute to reinforcing efficacy.

scholarly journals Very Light Daily Smoking in Young Adults: Relationships Between Nicotine Dependence and Lapse

2020 ◽  
Author(s):  
Melinda L. Ashe ◽  
Stephen Jeffrey Wilson
Keyword(s):  
Young Adults ◽  
Nicotine Dependence ◽  
Proportional Hazards ◽  
Baseline Period ◽  
Cox Proportional Hazards ◽  
Daily Smoking ◽  
Monetary Rewards ◽  
Cox Proportional Hazards Models ◽  
Cigarette Dependence ◽  
Dependence Measures

Introduction: Very light daily smoking is increasingly common among young adults. Evidence suggests that levels of nicotine dependence vary significantly among young adults who engage in very light daily smoking. However, the links between dependence and clinically relevant outcomes (e.g., lapse) in this population remain unclear. The goal of this study was to address this gap by evaluating how well different nicotine dependence scales predict lapse behavior among very light daily smoking young adults. Methods: Very light daily smokers (1-5 cigarettes/day) aged 18-25 participated in an initial laboratory session, during which nicotine dependence was assessed using four commonly used measures: the Fagerstrӧm Test for Cigarette Dependence (FTCD), the Hooked On Nicotine Checklist (HONC), the Transdisciplinary Tobacco Use Research Centers (TTURC) Nicotine Dependence Inventory, and the Wisconsin Inventory of Smoking Dependence Motives (WISDM). After a baseline period, eligible participants (n=40) completed a 10-day abstinence incentive period in which they attempted to refrain from smoking to earn monetary rewards. Cox proportional hazards models were used to test whether dependence predicted days to first lapse. Results: FTCD scores significantly predicted days to lapse, as did scores on the FTCD item assessing time to first cigarette of the day (TTFC). No other dependence measures predicted time to lapse. Both the FTCD and TTFC continued to independently predict time to lapse after controlling for smoking frequency and duration. Conclusions: The FTCD may be a particularly useful tool for capturing clinically meaningful variability in nicotine dependence among young adults who engage in very light daily smoking.

scholarly journals E-cigarette Use, Tobacco Product Polyuse, and Motivations for Use among Baltimore Young Adults

2019 ◽  
Vol 6 (5) ◽  
pp. 427-437
Author(s):  
Daisy Le ◽  
Meghan B. Moran ◽  
Rebkha Atnafou ◽  
Pamela A. Matson ◽  
Miranda R. Jones ◽  
...  
Keyword(s):  
Young Adults ◽  
Tobacco Use ◽  
Text Messaging ◽  
Risk Perceptions ◽  
Tobacco Cessation ◽  
Tobacco Product ◽  
Urban Setting ◽  
Cigarette Use ◽  
Use Patterns ◽  
History Of

Objective: We examined reasons for e-cigarette use, tobacco product polyuse, and tobacco cessation interest among tobacco-using young adults from an urban setting. Methods: Participants (N = 97) completed a risk factor survey. Descriptive statistics and prevalence estimates of polytobacco use patterns, motivations for tobacco use, tobacco cessation interest, and beliefs and risk perceptions about tobacco use were explored. Results: All participants had a history of polyuse, and 85% were current polyusers. Stress was the primary reason reported for tobacco use. Compared to single-product users, current polyusers also were more likely to mention environment and cheap cost as reasons for use. Most participants perceived cigarettes to be as addictive as cocaine or heroin, although this perception was less common among e-cigarette users than non-users. Among study participants, 59% reported wanting to stop using tobacco completely. Among current polyusers, those that used e-cigarettes were more likely to report cessation attempts during the past year and express interest in enrolling in a quit smoking text messaging program. Conclusion: In our sample there was a high prevalence of polytobacco product use and complex tobacco use patterns among young adults, both in and out of college, from an urban community.

scholarly journals Changes in Use Patterns Over 1 Year Among Smokers and Dual Users of Combustible and Electronic Cigarettes

2019 ◽  
Vol 22 (5) ◽  
pp. 672-680 ◽  
Author(s):  
Megan E Piper ◽  
Timothy B Baker ◽  
Neal L Benowitz ◽  
Douglas E Jorenby
Keyword(s):  
Electronic Cigarettes ◽  
Community Sample ◽  
Cigarette Use ◽  
Dual Use ◽  
Use Patterns ◽  
Quit Smoking ◽  
Longitudinal Observational Study ◽  
Cigarette Dependence ◽  
Point Prevalence Abstinence

Abstract Background Dual use of combustible and electronic cigarettes (e-cigarettes) is a growing use pattern; more than half of e-cigarette users are dual users. However, little is known regarding the course of dual use; for example, the likelihood of discontinuation of either combustible or e-cigarettes or both. Methods Adult daily smokers and dual users (daily smokers who also vaped at least once per week) who did not intend to quit use of either product in the next 30 days participated in a longitudinal, observational study (N = 322, 51.2% women, 62.7% white, mean age = 42.27 [SD = 14.05]). At baseline, participants completed demographics and smoking and vaping history assessments. They also reported daily cigarette and e-cigarette use via timeline follow-back assessment and provided a breath sample for carbon monoxide assay at 4-month intervals for 1 year. Results Of those who completed the year 1 follow-up, 1.9% baseline smokers and 8.0% dual users achieved biochemically confirmed seven-day point-prevalence abstinence from combustible cigarettes (χ2 = 4.57, p = .03). Of initial dual users, by 1 year 43.9% were smoking only, 48.8% continued dual use, 5.9% were vaping only, and 1.4% abstained from both products. Among baseline smokers, 92.3% continued as exclusive smokers. Baseline dual users who continued e-cigarette use were more likely to be white and report higher baseline e-cigarette dependence. Conclusions In this community sample, the majority of dual users transitioned to exclusive smoking. A higher percentage of dual users quit smoking than smokers, but attrition and baseline differences between the groups compromise strong conclusions. Sustained e-cigarette use was related to baseline e-cigarette dependence. Implications This research suggests that dual use of combustible and e-cigarettes is not a sustained pattern for the majority of dual users, but it is more likely to be a continued pattern if the user is more dependent on e-cigarettes. There was evidence that dual users were more likely to quit smoking than exclusive smokers, but this may be due to factors other than their dual use.

scholarly journals Very Light Daily Smoking in Young Adults: Relationships Between Nicotine Dependence and Lapse

2020 ◽  
Author(s):  
Melinda L Ashe ◽  
Stephen J Wilson
Keyword(s):  
Young Adults ◽  
Nicotine Dependence ◽  
Proportional Hazards ◽  
Baseline Period ◽  
Cox Proportional Hazards ◽  
Daily Smoking ◽  
Monetary Rewards ◽  
Cox Proportional Hazards Models ◽  
Cigarette Dependence ◽  
Dependence Measures

Abstract Introduction Very light daily smoking is increasingly common among young adults. Evidence suggests that levels of nicotine dependence vary significantly among young adults who engage in very light daily smoking. However, the links between dependence and clinically relevant outcomes (eg, lapse) in this population remain unclear. The goal of this study was to address this gap by evaluating how well different nicotine dependence scales predict lapse behavior among very light daily smoking young adults. Aims and Methods Very light daily smokers (1–5 cigarettes/day) aged 18–25 participated in an initial laboratory session, during which nicotine dependence was assessed using four commonly used measures: the Fagerstrӧm Test for Cigarette Dependence (FTCD), the Hooked On Nicotine Checklist (HONC), the Transdisciplinary Tobacco Use Research Centers (TTURC) Nicotine Dependence Inventory, and the Wisconsin Inventory of Smoking Dependence Motives (WISDM). After a baseline period, eligible participants (n = 40) completed a 10-day abstinence incentive period in which they attempted to refrain from smoking to earn monetary rewards. Cox proportional hazards models were used to test whether dependence predicted days to first lapse. Results FTCD scores significantly predicted days to lapse, as did scores on the FTCD item assessing time to first cigarette of the day (TTFC). No other dependence measures predicted time to lapse. Both the FTCD and TTFC continued to independently predict time to lapse after controlling for smoking frequency and duration. Conclusions The FTCD may be a particularly useful tool for capturing clinically meaningful variability in nicotine dependence among young adults who engage in very light daily smoking. Implications This is the first study to directly link self-reported nicotine dependence with the ability to achieve and maintain abstinence among very light daily smoking young adults. The results may aid clinicians in selecting among variable measures of nicotine dependence when assessing and treating this population.

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