Reasons for Transition From Electronic Cigarette Use to Cigarette Smoking Among Young Adult College Students

Marzena Hiler; Tory R Spindle; Danielle Dick; Thomas Eissenberg; Alison Breland; Eric Soule

doi:10.1016/j.jadohealth.2019.09.003

Reasons for Transition From Electronic Cigarette Use to Cigarette Smoking Among Young Adult College Students

J Adolesc Health. 2020 Jan;66(1):56-63. doi: 10.1016/j.jadohealth.2019.09.003. Epub 2019 Nov 5.

Authors

Marzena Hiler¹, Tory R Spindle², Danielle Dick³, Thomas Eissenberg⁴, Alison Breland⁴, Eric Soule⁵

Affiliations

¹ Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia; Department of Psychology, Virginia Commonwealth University, Richmond, Virginia. Electronic address: Marzenamhiler@gmail.com.
² Behavioral Pharmacology Research Unit, Johns Hopkins University School of Medicine, Baltimore, Maryland.
³ Department of Psychology, Virginia Commonwealth University, Richmond, Virginia; Department of Human and Molecular Genetics, Virginia Commonwealth University, Richmond, Virginia.
⁴ Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia; Department of Psychology, Virginia Commonwealth University, Richmond, Virginia.
⁵ Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia; Department of Health Education and Promotion, East Carolina University, Greenville, North Carolina. Electronic address: soulee18@ecu.edu.

Abstract

Purpose: Longitudinal studies indicate that e-cigarette use among youth and young adults is associated with cigarette smoking initiation. The purpose of this study was to identify reasons why nonsmoking young adults transition from e-cigarette use to cigarette smoking.

Methods: The study used concept mapping (CM), a mixed-method participatory approach. Fifty-five college students who endorsed initiation of e-cigarettes before cigarettes (lifetime e-cigarette uses ≥ 100 and ≥ 100 cigarettes in lifetime) completed at least one part of the study. In an online program, participants brainstormed (n = 54) statements describing reasons for transition from e-cigarette use to cigarette smoking, sorted statements (n = 46) into conceptually similar categories, and rated (n = 47) how true each statement was for them.

Results: Participants generated 60 unique statements, and multidimensional scaling analysis generated eight thematic clusters characterizing reasons for transition which included the following: "Sharing with Others," "Psychological Coping," "Cigarette Appeal," "Reinforcing Effects of Cigarettes," "Accessibility," "Social Influence," "Vaping Stigma," and "Vaping Deficiencies." Participants rated "Sharing with Others" and "Psychological Coping" highest (most true) and "Vaping Deficiencies" lowest (least true). For college students, the ability to share cigarettes with peers and access cigarettes from peers and smoking for stress/anxiety management were among the top reasons for transition.

Conclusions: Results suggest that tailored prevention efforts aimed at reducing cigarette smoking uptake among college students who use tobacco as a means for psychological coping or social facilitation may be warranted. Furthermore, regulatory decisions aimed at limiting cigarette appeal, reinforcing effects, and accessibility may be relevant to reducing transition.

Keywords: Cigarette smoking; College students; Electronic cigarette; Tobacco transition; Tobacco use; Young adults.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

MeSH terms

Adolescent
Cigarette Smoking*
Electronic Nicotine Delivery Systems*
Female
Humans
Male
Students
Vaping*
Young Adult

Abstract

Publication types

MeSH terms

Grants and funding