Differentiating Reasons for Young Adult E-cigarette Use Using Maximum Difference Choice Models.
Friday, March 17, 2023
Posted by: Natalia Gromov
Stone
MD, Braymiller JL, Strong DR, Cwalina SN, Dimofte CV, Barrington-Trimis JL.
Differentiating Reasons
for Young Adult E-cigarette Use Using Maximum Difference Choice Models.
Nicotine Tob Res. 2023 Jan 31:ntad017. doi: 10.1093/ntr/ntad017. Epub ahead of
print. PMID: 36719042.
Introduction. Understanding
the reasons young adults use e-cigarettes (i.e., vape) - and whether these
motivations vary across groups - is essential for informing tobacco regulatory
efforts.
Methods. An
online panel of young adults who vape (n=230; age=18-30) completed a maximum
difference discrete choice task for 15 reasons for vaping. Over 9 choice sets,
participants were presented a subset of 5 reasons and selected the most and
least important. Hierarchical bayesian analysis estimated the relative
importance of each reason. Latent class analysis (LCA) identified groups with
similarly ranked reasons for use. Multinomial regression evaluated the
association between sample characteristics and class membership.
Results. Overall,
relaxation had the highest probability of being the most important reason for
use (14.8%), followed by harm reduction (13.2%), and flavors (10.3%). LCA
identified five distinct classes, based on top reasons for use: (1) cessation
(cigarette cessation [20.2%]; n=80); (2) dependence (relaxation [20.5%] and
unable to quit [19.2%]; n=21); (3) relaxation (relaxation [20.6%]; n=66); (4)
socializing (socializing [22.2%]; n=27); and (5) variable (boredom [10.5%] and
acceptability [10.2%]; n=36). Participants who were older, smoked cigarettes,
or vaped more frequently were more likely to belong to the cessation class
while those who were younger or more e-cigarette dependent were more likely to
belong to the dependence class.
Conclusions. Perceived
reasons why young adults vape are highly heterogeneous and dependent on the
type of user. Tobacco regulatory efforts targeting distinct types of vapers are
needed to minimize the adverse public health impact of vaping without
compromising appeal for smoking cessation.
Implications. E-cigarette
use remains high among young adults, with flavors, cost, and harm reduction
(vs. combustible cigarettes) among the mostly commonly reported reasons for
use. Yet, little is known about how relatively important these reasons are to
the individual. Leveraging a maximum difference task, young adults' reasons for
use were evaluated on a common interval scale and groups sharing similar
reasons identified. Smoking cessation, dependence, relaxation, socialization,
and boredom were respectively the most important reasons for use among five
classes of vapers. E-cigarette regulatory policies should consider the distinct
reasons for use as to not compromise their appeal for smoking cessation.
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