Adult Vapers Research Articles

Socioeconomic patterning of vaping by smoking status among UK adults and youth

BackgroundSmoking contributes significantly to socioeconomic health inequalities. Vaping has captured much interest as a less harmful alternative to smoking, but may be harmful relative to non-smoking. Examining inequalities in vaping by smoking status, may offer insights into potential impacts of vaping on socioeconomic inequalities in health.MethodsData were from 3291 youth (aged 10–15) and 35,367 adults (aged 16+) from wave 7 (2015–17) of the UK Household Longitudinal Study. In order to adjust for biases that could be introduced by stratifying on smoking status, marginal structural models were used to estimate controlled direct effects of an index of socioeconomic disadvantage (incorporating household education, occupation and income) on vaping by smoking status (among adults and youth), adjusting for relevant confounders and for selection into smoking states. We also estimated controlled direct effects of socioeconomic disadvantage on being an ex-smoker by vaping status (among adult ever-smokers; n = 18,128).ResultsSocioeconomic disadvantage was associated with vaping among never smoking youth (OR for a unit increase in the socioeconomic index: 1.17; 95%: 1.03–1.34), and among ex-smoking adults (OR: 1.17; 95% CI: 1.09–1.26), with little to no association among never smoking (OR: 0.98; 95% CI: 0.91–1.07) and current smoking (OR: 1.00; 95% CI: 0.93–1.07) adults. Socioeconomic disadvantage was also associated with reduced odds of being an ex-smoker among adult ever-smokers, but this association was moderately weaker among those who vaped (OR: 0.88; 95% CI: 0.82–0.95) than those who did not (OR: 0.82; 95% CI: 0.80–0.84; p-value for difference = 0.081).ConclusionsInequalities in vaping among never smoking youth and adult ex-smokers, suggest potential to widen health inequalities, while weaker inequalities in smoking cessation among adult vapers indicate e-cigarettes could help narrow inequalities. Further research is needed to understand the balance of these opposing potential impacts, and how any benefits can be maximised whilst protecting the vulnerable.

Electronic cigarette use among individuals with a self-reported eating disorder diagnosis.

The primary study aim was to examine whether rates of using e-cigarettes ("vaping") to lose weight are elevated among American adults who self-report having an eating disorder (ED). Adult vapers who reported either currently having an ED (n=178; 72.5% women, 83.7% White, mean age 33.26 [SD=8.35]years) or no ED history (n=433; 54.7% women, 83.4% White, 35.98 [SD=11.71]years) completed an anonymous survey. Relative to participants reporting no ED history, participants who reported currently having an ED were more likely to report vaping to lose/control weight, because it can be concealed from others, and due to the availability of sweet flavors. Participants reporting a current ED also were more likely to vape daily, to use higher nicotine concentrations, and to vape to relieve negative affect than were individuals without EDs. Individuals who self-reported currently having an ED endorsed vaping motives that are consistent with eating pathology (e.g., substance-induced weight loss, hiding compensatory behaviors from others). They also were more likely to vape daily and to use higher nicotine concentrations, raising health concerns. The findings suggest that treatment providers should screen for e-cigarette use in clients seeking ED treatment.

Changes in Puffing Topography and Nicotine Consumption Depending on the Power Setting of Electronic Cigarettes.

The study purpose was to evaluate changes in puffing topography of experienced electronic cigarette users (vapers) when changing power settings in electronic cigarette battery devices. Experienced adult vapers (n = 21) were recruited. Participants used their own liquids and an atomizer and battery provided by the researchers. Two 30-minute sessions were performed, with the device power set at 6 W and 10 W, in a randomized, crossover, participant-blinded design. Puff number and duration (mean [SD]) were recorded in the provided electronic cigarette battery device, whereas the atomizers were weighted before and after use to determine liquid and nicotine consumption. Puff number and puff duration were lower at 10 W (46 [16] puffs and 3.8 [0.8] s) compared with 6 W (57 [20] puffs and 4.6 [1.0] s). Liquid and nicotine consumption was higher at 10 W (373 [176] mg and 4.2 [2.4] mg, respectively) compared with 6 W (308 [165] mg and 3.5 [2.3] mg, respectively). Vapers reported more aerosol volume and ease of use at 10 W compared with 6 W. The study identified an attempt for compensatory puffing patterns and nicotine self-titration, with a change in puffing patterns (puff number and duration) observed when changing the power settings of an e-cigarette device. Compensatory smoking behavior and nicotine self-titration is a well-established phenomenon. In electronic cigarettes, changing nicotine concentration in the liquid has been shown to trigger a compensatory puffing pattern. Herein, power setting of the electronic cigarette device was found to be a parameter associated with changes in puffing behavior, whereas higher power was preferable for the participants. These findings could contribute to the understanding of patterns of electronic cigarette use and could explain the preference of dedicated vapers to higher power devices. Additionally, laboratory studies evaluating aerosol emissions should consider using different puffing patterns according to the power settings tested.

Type of E-Cigarette Device Used Among Adolescents and Young Adults: Findings From a Pooled Analysis of Eight Studies of 2166 Vapers.

A recent study of adult smokers who vape found that disposable/cigalike electronic (e-) cigarette devices were more commonly used than later generation devices. However, whether these trends reflect patterns among adolescents and young adults, many of whom have limited or no history of combustible cigarette use, has not been studied. Participants were drawn from eight locally, regionally, and US nationally representative studies. Surveys took place between Fall 2014 and Spring 2016; participants were residents of California (3 studies), Texas (2 studies), Connecticut (1 study), or randomly selected from the US population (2 studies). Data were collected from middle and high school students (4 studies), young adults under 30 (3 studies), or a mixture (1 study) to assess type of e-cigarette device used among past-30 day e-cigarette users: disposable/cigalike, or later generation e-cigarette device. Fewer than 15% of participants in each study reported primarily using a disposable/cigalike device in the past month (across all studies: 7.5%; 95%CI: 4.9%, 10.5%). The proportion using later generation devices ranged from 58% to 86% across studies; overall, 77.0% (95%CI: 70.5%, 82.9%) reported primary use of a later generation device. Combined, 13.2% (95%CI: 5.9%, 22.8%) reported "don't know" or were missing data. Among adolescent and young adult e-cigarette users, primary use of disposable/cigalike devices was rare. Future research should continue to evaluate the type of device used by adolescents and young adults, as these data may be relevant to regulatory oversight of e-cigarettes recently acquired by the Food and Drug Administration Center for Tobacco Products. In this pooled analysis of adolescent and young adult vapers, primary use of later generation e-cigarette devices was substantially more common than use of disposable/cigalike devices. The type of device predominantly used by adolescents and young adults has regulatory implications for policy to reduce adolescent use of e-cigarettes.

Predictors of Adult E-Cigarette Users Vaporizing Cannabis Using E-Cigarettes and Vape-Pens

ABSTRACTBackground: Given limited extant research, we assessed the use of portable, battery-powered cannabis vaporizers by adult e-cigarette users. Methods: 522 adult vapers completed an online survey. Demographics; lifetime and past-month cannabis vaporization via e-cigarettes/vape-pens; preferences for hash oil, D-9-tetrahydrocannabinol (THC) wax, or dried buds; and cannabis vaporization beliefs and motives were examined. Demographics, age of e-cigarette onset, e-cigarette use frequency, state-level legal status of cannabis, cannabis vaping beliefs/motives, and impulsivity were examined as predictors of lifetime cannabis vaporization, past-month cannabis vaporization, and cannabis vaping frequency. Results: E-cigarette users reported lifetime (17.8%) and past-month (11.5%) cannabis vaporization. Vapers preferred hash oil (LT/PM 45.5/47.5%), THC wax (15.2/32.2%), and dried buds (39.4/35.6%). Motivations to vape cannabis included: it tastes better (39.3/37.9%), is healthier (42.9/39.7%), is easier to conceal/hide (35.7/46.6%), does not smell as strong (42.9/39.7%), is more convenient (42.9/27.6%), and produces a stronger/better high (58.1/40.7%) than smoking cannabis. Lifetime and past-month cannabis vaporization, respectively, were associated with initiating e-cigarette use at an earlier age (odds ratio (OR) = 0.09/0.88), being impulsive (OR = 2.25/3.23), having poor self-control (OR = 2.23/1.85), and vaporizing cannabis because it is easier to conceal/hide (OR = 2.45/2.48) or is more convenient than smoking cannabis (OR = 5.02/2.83). Frequency of vaping cannabis was associated with heavier e-cigarette use (ηp2 = 0.10) and impulsivity (ηp2 = 0.09). Conclusions: Adult e-cigarette users are vaporizing cannabis using e-cigarettes/vape-pens. Efforts to curb cannabis vaporization may benefit from targeting impulsivity in users and regulating device features that facilitate or promote convenient, inconspicuous cannabis use.

Effects of sweet flavorings and nicotine on the appeal and sensory properties of e-cigarettes among young adult vapers: Application of a novel methodology

IntroductionProduct characteristics that impact e-cigarette appeal by altering the sensory experience of vaping need to be identified to formulate evidence-based regulatory policies. While products that contain sweet flavorings and produce a “throat hit” (i.e., desirable airway irritation putatively caused by nicotine) are anecdotally cited as desirable reasons for vaping among young adults, experimental evidence of their impact on user appeal is lacking. This experiment applied a novel laboratory protocol to assess whether: (1) sweet flavorings and nicotine affect e-cigarette appeal; (2) sweet flavorings increase perceived sweetness; (3) nicotine increases throat hit; and (4) perceived sweetness and throat hit are associated with appeal. MethodsYoung adult vapers (N=20; age 19–34) self-administered 20 standardized doses of aerosolized e-cigarette solutions varied according to a 3 flavor (sweet [e.g., cotton candy] vs. non-sweet [e.g., tobacco-flavored] vs. flavorless)×2 nicotine (6mg/mL nicotine vs. 0mg/mL [placebo]) double-blind, cross-over design. Participants rated appeal (liking, willingness to use again and perceived monetary value), perceived sweetness and throat hit strength after each administration. ResultsSweet-flavored (vs. non-sweet and flavorless) solutions produced greater appeal and perceived sweetness ratings. Nicotine produced greater throat hit ratings than placebo, but did not significantly increase appeal nor interact with flavor effects on appeal. Controlling for flavor and nicotine, perceived sweetness was positively associated with appeal ratings; throat hit was not positively associated with appeal. ConclusionsFurther identification of compounds in e-cigarette solutions that enhance sensory perceptions of sweetness, appeal, and utilization of e-cigarettes are warranted to inform evidence-based regulatory policies.