E‐cigarettes and expectancies: why do some users keep smoking?

Abstract

Background and aims Many smokers who have tried electronic cigarettes (“e-cigarettes”) continue to smoke, perhaps influenced by their beliefs about the outcomes of using e-cigarettes (“e-cigarette expectancies”). The primary aims of this study were to compare expectancies of dual users to former smokers, and to examine the association between expectancies and intentions to quit or reduce “vaping” among former smokers. Design and Setting A large cross-sectional online survey of e-cigarette users conducted in the USA. Participants We surveyed current e-cigarette users (N=1815), including both current cigarette smokers (“dual users,” n=381) and former smokers (n=1434). We further subdivided former smokers into those with (n=686) and without (n=748) intentions to reduce or quit e-cigarette use. Measurements The primary outcomes were self-reported past-month smoking status and, among former smokers, current intentions to reduce or quit e-cigarette use, both adjusted for potential confounders. E-cigarette expectancy items were primarily derived from a previously validated measure of smoking expectancies. Findings Dual users reported less positive expectancies than former smokers about e-cigarettes, rating e-cigarettes as more physically irritating (β=−0.10, p<0.001) and addictive (β=0.06, p=0.016), as well as less satisfying (β= −0.11, p<0.001). Former smokers with intentions to quit e-cigarettes also rated e-cigarettes less positively than former smokers without intentions to quit e-cigarettes, rating them more likely to damage health (β=0.16, p<0.001) and cause addiction (β=0.10, p<0.001), but less likely to taste good (β= −0.08, p=0.006). Conclusions Positive e-cigarette expectancies among e-cigarette users are associated with a greater likelihood of having quit smoking, but lower likelihood of intention to quit e-cigarette use.

Overview of Electronic Nicotine Delivery Systems: A Systematic Review

“…Two hundred and fifty articles 153,192–194,197,203,239,265,271,304,323–326,329,332,333,335–339,341–344,346,348,350,351,353–362,365,367–369,372,374–376,378–381,384,388,390,393–396,404–406,408,414–416,418,420–422,425,426,432,434,436,440,441,444–450,453–456,459–462,465,468,472,475,476,478,488,489,491,494,496–498,500,502,504,506–646 have been published on vaping patterns.…”

Electronic Cigarette Expectancies in Smokers with Psychological Distress

“…However, there is some evidence that positive ENDS expectancies are associated with sustained ENDS use, and these individuals may be the subset who transition from combustible cigarettes to ENDS. 35 …”

“Essentially, All Models Are Wrong, but Some Are Useful”: A Preliminary Conceptual Model of Co-occurring E-cig and Alcohol Use

“…Preliminary work suggests that these impulsive personality traits are related to e-cig use through more positive attitudes towards e-cigs [10], although this work has been done in cross-sectional samples, thereby preventing the examination of prospective trajectories. Taken together, we suggest impulsive personality is a viable risk factor for both e-cig and alcohol use through the development of positive expectancies of e-cig use [9–10, 16] and alcohol use [14] (see Figure 1, box A and B). Due to the preliminary nature of this work, we do not make specific claims concerning which impulsive personality traits predispose one to developing such positive e-cig expectancies and subsequent use, although the cigarette research literature suggests viability of sensation seeking and negative urgency as prime initial candidates [14].…”

“…E-cig users have positive expectancies of e-cig use [16], which could be one way through which impulsive personality is related to e-cig use. Research with cigarettes indicates that sensation seeking and negative urgency are related to cigarette use initiation in part through reinforcement expectancies of cigarette use [17], leading us to hypothesize that this might also occur with e-cigs.…”