The study aims to recruit 100 current cigarette smokers (50 young adults ages 21-34; 50 older adults ages 35-65) who have tried vaping or are currently vaping (dual users). The study will examine the trajectories in tobacco use (cigarettes and/or ENDS), including the nuanced differences in ENDS use (i.e., detailed device characteristics, user preferences, patterns of use), according to smoker age group.
Study Type
OBSERVATIONAL
Enrollment
100
Center for Interdisciplinary Research on Nicotine Addiction
Philadelphia, Pennsylvania, United States
RECRUITINGDigital Diary (Mobile App)
Participants will be asked to create an account for a mobile application that will serve as a digital diary to track any potential changes in tobacco product use, specifically ENDS and cigarette use, frequency of use for both products, and reasons for this change. The mobile app will ask the participant on a weekly basis whether there was any change to smoking and vaping habits from the past week. Collection of weekly data will provide granularity and a better understanding of the nuanced differences in ENDS use according to age group over the course of the 12-month enrollment period.
Time frame: 1 time per week for 5 months (Between Sessions)
ENDS Use (Open Ended Response)
To identify the factors that impact ENDS use, participants will be asked to provide personal reasons to start vaping or try new ENDS products, continue vaping, or quit vaping.
Time frame: 5-6 months (at three time points)
ENDS Risk Beliefs
Participants will be asked questions adapted to ENDS use about their product perceptions, including measures of risk beliefs.
Time frame: 5-6 months (at three time points)
ENDS Perceived Health Risks
Participants will be asked questions adapted to ENDS use about their product perceptions, including measures of perceived health risks.
Time frame: baseline
ENDS Attitudes & Intentions
Participants will be asked to report on attitudes and intentions towards using ENDS, and social norms (the number of friends/family who smoke and/or vape and what friends/family behaviors/beliefs are on products; what the participants' beliefs about others approval of products are).
Time frame: 5-6 months (at three time points)
ENDS Personal Experience
Participants will be asked about personal experiences with ENDS use (physical sensation, experienced effects, ability to satisfy cravings, product problems, convenience of use, cost, regulation).
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Time frame: 5-6 months (at three time points)
Subjective Cigarette Ratings
Participants will provide subjective ratings of all cigarettes smoked during laboratory sessions using a 14-item, 100 mm visual analog scale (VAS) of cigarette characteristics (e.g., taste) used by the tobacco industry and our laboratory. Anchors are item-specific (e.g., taste: 0 = "very bad," 100 = "very good"), with lower scores indicating less favorable ratings. Subjective cigarette ratings will be assessed after each cigarette smoked in the laboratory across all sessions. The participant will also complete a modified version of the same form at each session for ENDS use. Participant ENDS subjective ratings will be collected after each vaping period in the laboratory (if applicable).
Time frame: 5-6 months (at three time points)
Puff Duration (via smoking topography)
Both smoking and vaping (if applicable) behaviors will be assessed using video-scored measures of topography (i.e., puffing behavior), which includes the number of puffs taken, and total inter-puff interval. A digital timestamp feature in opensource video editing software will be used to estimate start and end times for individual puffs based on various physical cues (i.e., inhaling, glowing cigarette tips or ENDS device).
Time frame: 5-6 months (at three time points)
Nicotine Metabolites (Urine Sample)
Spot urine samples will be collected using acid washed collection cups. Urine will be used to measure metals, aldehyde metabolites, cotinine, creatinine. Biospecimens will be frozen at \< -80°C in freezers operated under a strict quality control system. The time in which each participant last vaped and when the biospecimen samples were collected will be recorded.
Time frame: 5-6 months (at three time points)
Carbon Monoxide (CO) assessment
CO levels will be measured using a breath CO monitor to assess tobacco exposure.The CO monitor is a handheld device that uses a disposable mouthpiece, reports CO in parts per million (ppm), and takes about 3 minutes to administer. Participants will smoke a cigarette of choice in the laboratory, and CO measurements will be collected to assess the difference before and after the cigarette smoked, or CO boost, to measure smoke exposure from a single cigarette. Collection of these secondary measures will allow the team to evaluate differences in tobacco and nicotine exposure between age groups, which may be impacted by participants' cigarette and ENDS product of choice and the potentially differing patterns of use between products.
Time frame: 5-6 months (at three time points)
Craving
Participants will report cigarette craving and nicotine withdrawal symptoms at the onset of each visit. Craving will be assessed using a summary score and two factor subscales (i.e., desire to smoke and craving due to anticipation of negative affect relief) from the 32-item Questionnaire on Smoking Urges (QSU).
Time frame: 5-6 months (at three time points)
Withdrawal
Withdrawal will be assessed using a summary score from the 20-item (21 items at Session 1 \[D0\]) revised version of the Withdrawal Symptom Checklist (WSC-W \[1-week frame of reference\]).
Time frame: 5-6 months (at three time points)
Attitude & Intention to Use Product
Participants' attitudes and intentions toward their cigarette packs will be assessed, similar to the lab's previous work on cigarette smoking that applied the Reasoned Action Approach. Likert-type semantic differential scales will be used (likely to use/not use, enjoyable/non enjoyable, harmful/not harmful). Participants will complete the Attitudes and Intentions Questionnaire across all sessions after smoking each lab cigarette. The participant will also complete a modified version of the same form at each session for ENDS use. Participant ENDS Attitudes \& Intentions will be collected after each vaping period in the laboratory (if applicable).
Time frame: 5-6 months (at three time points)