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

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.

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Ecological momentary assessment of various tobacco product use among young adults

Addictive Behaviors ◽

10.1016/j.addbeh.2018.12.014 ◽

2019 ◽

Vol 92 ◽

pp. 38-46 ◽

Cited By ~ 7

Author(s):

Carla J. Berg ◽

Regine Haardörfer ◽

Jackelyn B. Payne ◽

Betelihem Getachew ◽

Milkie Vu ◽

...

Keyword(s):

Young Adults ◽

Ecological Momentary Assessment ◽

Tobacco Product ◽

Product Use ◽

Ecological Momentary ◽

Momentary Assessment

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Measuring Poly-tobacco Product Use with Ecological Momentary Assessment

Tobacco Regulatory Science ◽

10.18001/trs.6.6.6 ◽

2020 ◽

Vol 6 (6) ◽

pp. 423-435

Author(s):

Nicholas G. Griffiths ◽

Jessica L. Fetterman ◽

Comreen Vargees ◽

Hasmeena Kathuria ◽

Stine Grodal ◽

...

Keyword(s):

Real Time ◽

Ecological Momentary Assessment ◽

Real Life ◽

Tobacco Product ◽

Longitudinal Methods ◽

Baseline Questionnaire ◽

Product Use ◽

Concurrent Use ◽

Ecological Momentary ◽

Momentary Assessment

Objectives: Poly-tobacco product use is common among tobacco users, but it is challenging to assess patterns of use in real-life contexts. The objective of this study is to determine whether intensive longitudinal methods are feasible for assessing concurrent use of multiple tobacco products. Methods: Overall, 28 participants completed a baseline questionnaire and 7 days of ecological momentary assessment data collection, including end-of-day, random, and real-time reporting. Results: When estimating use of cigarettes, vaping products, and other products individually, there were moderate correlations between baseline questionnaire estimates, end-of-day estimates, and random estimates (ρ= 0.379–0.640); however, daily totals of all products combined were poorly correlated (ρ = 0.198–0.461). Baseline questionnaire estimates were higher than random estimates for each product (median difference 1.5–7.0 products per day). End-of-day estimates were more consistent with the baseline questionnaire. There was low compliance with real-time product use reports. Conclusions: Random or daily reporting are feasible for poly-tobacco use assessment, but methods are needed to reconcile differences in estimates. Accurate measurement of poly-tobacco product use is needed to assess health impacts and inform policy.

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Real-Time Context of Tobacco Marketing Exposure and Community Vulnerability—An Ecological Momentary Assessment Among Young Adults

Annals of Behavioral Medicine ◽

10.1093/abm/kaab066 ◽

2021 ◽

Author(s):

Julia C Chen-Sankey ◽

Judy van de Venne ◽

Susan Westneat ◽

Basmah Rahman ◽

Shanell Folger ◽

...

Keyword(s):

Young Adults ◽

Real Time ◽

Ecological Momentary Assessment ◽

Text Messaging ◽

Tobacco Product ◽

Tobacco Marketing ◽

Vulnerable Communities ◽

Ecological Momentary ◽

Momentary Assessment ◽

Flavored Tobacco

Abstract Background Exposure to tobacco product marketing increases tobacco use among young adults, especially those from vulnerable communities (VCs). Purpose This study examined real-time tobacco marketing exposure among young adults from vulnerable and non-vulnerable communities using Ecological Momentary Assessment (EMA). Methods This study used EMA data to assess context (e.g., location and activity) of tobacco marketing exposure using four text-messaging surveys per day over 2 weeks. Young adult non-current tobacco users living in Washington, D.C. (n = 146; ages 18–24) recorded 5,285 surveys, including 20 participants (13.2%) from VCs with high proportions of lower income and racial/ethnic minorities, and high smoking rates. Unadjusted and adjusted multilevel logistic regressions were used to assess the associations between exposure to any and flavored tobacco marketing, VC residence, and real-time context. Results Fifty-nine participants (40.4%) reported at least one tobacco marketing exposure and recorded 94 exposure moments. In adjusted models, odds of exposure were higher among VC residents (AOR = 2.6, 95% CI = 1.2–5.4), in the presence of anyone using tobacco versus no use (AOR = 4.0, 95% CI = 2.4–6.7), at store/retail (AOR = 17.0, 95% CI = 6.4–44.8), or outside/in transit (AOR = 4.1, 95% CI = 2.1–7.8) versus at home. VC residence (AOR = 7.2, 95% CI = 2.3–22.2) was the strongest predictor of flavored tobacco marketing exposure among all covariates examined. Conclusions Young adults are predominantly exposed to tobacco marketing in their daily lives through retail advertisements. Young adults from VCs are at increased risks of seeing any tobacco and especially flavored tobacco marketing. Policies that curtail tobacco retailer density and advertisement displays may reduce overall and differential tobacco marketing exposure.

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Measuring Poly-tobacco Product Use with Ecological Momentary Assessment

Tobacco Regulatory Science ◽

10.18001/tra.6.6.6 ◽

2020 ◽

Vol 6 (6) ◽

pp. 423-435

Author(s):

Nicholas G. Griffiths ◽

Jessica L. Fetterman ◽

Comreen Vargees ◽

Hasmeena Kathuria ◽

Stine Grodal ◽

...

Keyword(s):

Real Time ◽

Ecological Momentary Assessment ◽

Real Life ◽

Tobacco Product ◽

Longitudinal Methods ◽

Baseline Questionnaire ◽

Product Use ◽

Concurrent Use ◽

Ecological Momentary ◽

Momentary Assessment

Objectives: Poly-tobacco product use is common among tobacco users, but it is challenging to assess patterns of use in real-life contexts. The objective of this study is to determine whether intensive longitudinal methods are feasible for assessing concurrent use of multiple tobacco products. Methods: Overall, 28 participants completed a baseline questionnaire and 7 days of ecological momentary assessment data collection, including end-of-day, random, and real-time reporting. Results: When estimating use of cigarettes, vaping products, and other products individually, there were moderate correlations between baseline questionnaire estimates, end-of-day estimates, and random estimates (ρ = 0.379-0.640); however, daily totals of all products combined were poorly correlated (ρ = 0.198-0.461). Baseline questionnaire estimates were higher than random estimates for each product (median difference 1.5-7.0 products per day). End-of-day estimates were more consistent with the baseline questionnaire. There was low compliance with real-time product use reports. Conclusions: Random or daily reporting are feasible for poly- tobacco use assessment, but methods are needed to reconcile differences in estimates. Accurate measurement of poly-tobacco product use is needed to assess health impacts and inform policy.

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Polytobacco product use among current cigarette smokers in Hong Kong, China: results from population surveys (2015–17)

BMC Public Health ◽

10.1186/s12889-021-10341-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

S. L. Chau ◽

M. P. Wang ◽

Y. Wu ◽

D. Y. T. Cheung ◽

A. Kong ◽

...

Keyword(s):

Control Policy ◽

Tobacco Product ◽

Cigarette Use ◽

Related Factors ◽

Cigarette Smokers ◽

Tobacco Products ◽

Product Use ◽

Younger Age ◽

Current Cigarette ◽

Age And Sex

Abstract Background Polytobacco product use is increasingly popular, but little is known about the prevalence, trend, and factors of such use particularly in non-western countries. Method A representative sample of 1139 current cigarette smokers aged 15+ (84.1% male) were telephone interviewed in Tobacco Control Policy-related Surveys in 2015–2017. Information collected included poly-tobacco use (PTU), smoking and socio-demographic characteristics. Associations of current PTU with related factors were analyzed using logistic regression with adjustment for confounders. Prevalence was weighted by age and sex of current cigarette users in the general population. Results Eighty-four point one percent (95% CI 81.4–86.6%) were exclusive cigarette smokers. Fifteen point nine percent (13.4–18.6%) were current polytobacco product users, 12.3% (10.2–14.8%) used one tobacco product and 2.52% (1.59–3.97%) used two tobacco products in addition to cigarette. Cigarette use with cigar was more common (6.28%, 4.75–8.27%), and the least used product with cigarette was e-cigarette (1.05%, 0.44–2.50%). The changes in overall prevalence of PTU by number of products use varied in 3 years. Current PTU was associated with being male (AOR 2.01, 95% CI 1.12–3.61), younger age (AORs range from 1.34–4.65, P for trend < .001) and less ready to quit (2.08, 1.09–3.97). Conclusions Prevalence of PTU increased slowly by year, one tobacco product use with cigarette was more common. The most used tobacco product with cigarette was cigar. Being male, younger and less ready to quit were associated with current PTU.

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