The situational contexts and subjective effects of co-use of electronic cigarettes and alcohol among college students: An ecological momentary assessment (EMA) study

James J. Yang, Hsien Chang Lin, Tzung Shiang Ou, Zhaoxue Tong, Runze Li, Megan E. Piper, Anne Buu

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Introduction: Understanding the co-use of e-cigarettes and alcohol, including the situational contexts and subjective effects associated with co-use in real-time is necessary for validating this behavior and informing intervention. Yet, the sparse literature has built upon retrospective data. Methods: This study recruited 686 college students who were currently using e-cigarettes from three campuses in the Midwest and South of U.S in Fall 2019-Fall 2021. An on-line survey was conducted to measure e-cigarette use patterns, GPA, e-cigarette and alcohol dependence symptoms, and respiratory symptoms. A 7-day ecological momentary assessment was used to collect real-time data on e-cigarette and alcohol use, situational contexts and subjective effects. Results: Frequent drinking e-cigarette users reported more high-risk use behavior including consuming 6 + drinks/occasion and simultaneous use, and reported more e-cigarettes and alcohol related dependence symptoms and respiratory symptoms, compared to infrequent/non-drinker e-cigarette users. Alcohol quantity was positively associated with e-cigarette quantity among the high frequency drinking group. This study identified important use contexts that were associated with higher e-cigarette consumption including use of menthol or fruit flavored e-cigarettes, being in a car, and the presence of others. E-cigarette use and alcohol use both increased the levels of positive affect, physiological sensation, and craving for e-cigarettes, whereas only alcohol use significantly decreased negative affect. No interaction effects between e-cigarette use and alcohol use were found. Conclusions: The findings highlight the addiction and health risks associated with frequent co-use of e-cigarettes and alcohol, and also call for regulations on nontobacco flavorings in e-cigarette products.

Original languageEnglish (US)
Article number109594
JournalDrug and alcohol dependence
Volume239
DOIs
StatePublished - Oct 1 2022

All Science Journal Classification (ASJC) codes

  • Toxicology
  • Pharmacology
  • Psychiatry and Mental health
  • Pharmacology (medical)

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