Abstract
Rationale
Electronic nicotine delivery systems (ENDS or e-cigarettes) share salient features of combustible smoking, such as inhalation and exhalation behaviors, and evidence indicates that first- and second-generation ENDS generalize as smoking cues. The present study examined whether newer, tank-based third-generation ENDS (“mods”) also evoke smoking urges, and whether enhancing the visibility of exhaled aerosol clouds—by increasing the e-liquid vegetable glycerin (VG) content—strengthens the cue salience of ENDS.
Objectives
The objective was to assess the role of exhaled aerosol clouds on ENDS cue potency using a standardized laboratory paradigm designed to mimic real-world exposures.
Methods
Using a mixed design, young adult smokers (n = 50; mean age 26.5 years; ≥ 5 cigarettes/day) observed a study confederate drinking bottled water (control cue) and vaping an ENDS mod containing e-liquid with either high (73%) or low (0%) VG. Participants completed the Brief Questionnaire on Smoking Urges (BQSU) and visual analog scales (VAS) assessing cigarette and e-cigarette desire pre- and post-cue exposure.
Results
Increasing the e-liquid content of VG enhanced the size and visibility of the exhaled aerosol clouds and evoked a greater increase in smoking desire and a more sustained increase in e-cigarette desire relative to the low VG cue. Both cues elicited increases in smoking urges. These results remained after controlling for sex, prior ENDS experience, recent smoking behavior, and menthol preference.
Conclusions
Observation of tank-based ENDS use generalizes as a smoking cue and its cue salience is strengthened by increasing the e-liquid content of VG to enhance the visibility of the exhaled aerosol cloud.
Similar content being viewed by others
References
Baassiri M, Talih S, Salman R, Karaoghlanian N, Saleh R, el Hage R, Saliba N, Shihadeh A (2017) Clouds and “throat hit”: effects of liquid composition on nicotine emissions and physical characteristics of electronic cigarette aerosols. Aerosol Sci Technol 51:1231–1239. https://doi.org/10.1080/02786826.2017.1341040
Barrington-Trimis JL, Urman R, Berhane K, Unger JB, Cruz TB, Pentz MA, Samet JM, Leventhal AM, McConnell R (2016) E-cigarettes and future cigarette use. Pediatrics 138:e20160379–e20160379. https://doi.org/10.1542/peds.2016-0379
Beck AT, Ward CH, Mendelson M et al (1961) An inventory for measuring depression. Arch Gen Psychiatry 4:561. https://doi.org/10.1001/archpsyc.1961.01710120031004
Bold KW, Kong G, Camenga DR, Simon P, Cavallo DA, Morean ME, Krishnan-Sarin S (2018) Trajectories of E-cigarette and conventional cigarette use among youth. Pediatrics 141:e20171832. https://doi.org/10.1542/peds.2017-1832
Camenga DR, Delmerico J, Kong G, Cavallo D, Hyland A, Cummings KM, Krishnan-Sarin S (2014) Trends in use of electronic nicotine delivery systems by adolescents. Addict Behav 39:338–340. https://doi.org/10.1016/j.addbeh.2013.09.014
Carpenter MJ, Saladin ME, LaRowe SD et al (2014) Craving, cue reactivity, and stimulus control among early-stage young smokers: effects of smoking intensity and gender. Nicotine Tob Res 16:208–215. https://doi.org/10.1093/ntr/ntt147
Carter BL, Tiffany ST (2001) The cue-availability paradigm: the effects of cigarette availability on cue reactivity in smokers. Exp Clin Psychopharmacol 9:183–190
Centers for Disease Control (2017) QuickStats: percentage of adults who ever used an E-cigarette and percentage who currently use E-cigarettes, by age group—National Health Interview Survey, United States, 2016. MMWR Morb Mortal Wkly Rep 66:892. https://doi.org/10.15585/mmwr.mm6633a6
Cheng T (2014) Chemical evaluation of electronic cigarettes. Tob Control 23:ii11–ii17. https://doi.org/10.1136/tobaccocontrol-2013-051482
Choi K, Fabian L, Mottey N, Corbett A, Forster J (2012) Young adults’ favorable perceptions of snus, dissolvable tobacco products, and electronic cigarettes: findings from a focus group study. Am J Public Health 102:2088–2093. https://doi.org/10.2105/AJPH.2011.300525
Chu K-H, Allem J-P, Cruz TB, Unger JB (2016) Vaping on Instagram: cloud chasing, hand checks and product placement. Tob Control 26:575–578. https://doi.org/10.1136/tobaccocontrol-2016-053052
Clapp PW, Jaspers I (2017) Electronic cigarettes: their constituents and potential links to asthma. Curr Allergy Asthma Rep 17:79. https://doi.org/10.1007/s11882-017-0747-5
Coleman BN, Rostron B, Johnson SE et al (2017) Electronic cigarette use among US adults in the Population Assessment of Tobacco and Health (PATH) Study, 2013–2014. Tob Control. https://doi.org/10.1136/tobaccocontrol-2016-053462
Cox LS, Tiffany ST, Christen AG (2001) Evaluation of the brief questionnaire of smoking urges (QSU-brief) in laboratory and clinical settings. Nicotine Tob Res 3:7–16. https://doi.org/10.1080/14622200020032051
Dawkins L, Kimber C, Puwanesarasa Y, Soar K (2015) First- versus second-generation electronic cigarettes: predictors of choice and effects on urge to smoke and withdrawal symptoms. Addiction 110:669–677. https://doi.org/10.1111/add.12807
DeVito EE, Krishnan-Sarin S (2018) E-cigarettes: impact of E-liquid components and device characteristics on nicotine exposure. Curr Neuropharmacol 16:438–459. https://doi.org/10.2174/1570159X15666171016164430
Diener E, Emmons RA (1984) The independence of positive and negative affect. J Pers Soc Psychol 47:1105–1117
Drobes DJ, Tiffany ST (1997) Induction of smoking urge through imaginal and in vivo procedures: physiological and self-report manifestations. J Abnorm Psychol 106:15–25
Duke JC, Lee YO, Kim AE, Watson KA, Arnold KY, Nonnemaker JM, Porter L (2014) Exposure to electronic cigarette television advertisements among youth and young adults. Pediatrics 134:e29–e36. https://doi.org/10.1542/peds.2014-0269
Duke JC, Allen JA, Eggers ME, Nonnemaker J, Farrelly MC (2016) Exploring differences in youth perceptions of the effectiveness of electronic cigarette television advertisements. Nicotine Tob Res 18:1382–1386. https://doi.org/10.1093/ntr/ntv264
Etter J-F (2015) Explaining the effects of electronic cigarettes on craving for tobacco in recent quitters. Drug Alcohol Depend 148:102–108. https://doi.org/10.1016/J.DRUGALCDEP.2014.12.030
Farsalinos KE, Poulas K, Voudris V, Le Houezec J (2016) Electronic cigarette use in the European Union: analysis of a representative sample of 27?460 Europeans from 28 countries. Addiction 111:2032–2040. https://doi.org/10.1111/add.13506
First M, Spitzer R, Gibbon M, Williams J (1995) Structured clinical interview for DSM-IV Axis 1 Disorders, Research Version, Patient Edition (SCID-I/P). Biometrics Research, New York State Psychiatric Institute, New York, NY
Goldenson NI, Leventhal AM, Stone MD, McConnell RS, Barrington-Trimis JL (2017) Associations of electronic cigarette nicotine concentration with subsequent cigarette smoking and vaping levels in adolescents. JAMA Pediatr 171:1192–1199. https://doi.org/10.1001/jamapediatrics.2017.3209
Heatherton TF, Kozlowski LT, Frecker RC, Fagerström KO (1991) The Fagerström test for nicotine dependence: a revision of the Fagerström Tolerance Questionnaire. Br J Addict 86:1119–1127
Heishman SJ, Lee DC, Taylor RC, Singleton EG (2010) Prolonged duration of craving, mood, and autonomic responses elicited by cues and imagery in smokers: effects of tobacco deprivation and sex. Exp Clin Psychopharmacol 18:245–256. https://doi.org/10.1037/a0019401
Herrington JS, Myers C (2015) Electronic cigarette solutions and resultant aerosol profiles. J Chromatogr A 1418:192–199. https://doi.org/10.1016/j.chroma.2015.09.034
Johnston, LD, Miech RA, O’Malley PM, Bachman JG, Schulenberg JE, Patrick ME (2018) Monitoring the future national survey results on drug use: 1975–2017: overview, key findings on adolescent drug use. Institute for Social Research, The University of Michigan, Ann Arbor
Kim AE, Lee YO, Shafer P, Nonnemaker J, Makarenko O (2015) Adult smokers’ receptivity to a television advert for electronic nicotine delivery systems. Tob Control 24:132–135. https://doi.org/10.1136/tobaccocontrol-2013-051130
Kim H, Davis AH, Dohack JL, Clark PI (2017) E-cigarettes use behavior and experience of adults: qualitative research findings to inform E-cigarette use measure development. Nicotine Tob Res 19:190–196. https://doi.org/10.1093/ntr/ntw175
King AC, Smith LJ, McNamara PJ et al (2015) Passive exposure to electronic cigarette (e-cigarette) use increases desire for combustible and e-cigarettes in young adult smokers. Tob Control 24:501–504. https://doi.org/10.1136/tobaccocontrol-2014-051563
King AC, Smith LJ, Fridberg DJ, Matthews AK, McNamara PJ, Cao D (2016) Exposure to electronic nicotine delivery systems (ENDS) visual imagery increases smoking urge and desire. Psychol Addict Behav 30:106–112. https://doi.org/10.1037/adb0000123
King AC, Smith LJ, McNamara PJ, Cao D (2017) Second generation electronic nicotine delivery system vape pen exposure generalizes as a smoking cue. Nicotine Tob Res. https://doi.org/10.1093/ntr/ntw327
Kozlowski LT, Pillitteri JL, Sweeney CT, Whitfield KE, Graham JW (1996) Asking questions about urges or cravings for cigarettes. Psychol Addict Behav 10:248–260
Leventhal AM, Strong DR, Kirkpatrick MG, Unger JB, Sussman S, Riggs NR, Stone MD, Khoddam R, Samet JM, Audrain-McGovern J (2015) Association of electronic cigarette use with initiation of combustible tobacco product smoking in early adolescence. JAMA 314:700–707. https://doi.org/10.1001/jama.2015.8950
Levy DT, Borland R, Lindblom EN et al (2017) Potential deaths averted in USA by replacing cigarettes with e-cigarettes. Tob Control. https://doi.org/10.1136/tobaccocontrol-2017-053759
Maloney EK, Cappella JN (2016) Does vaping in E-cigarette advertisements affect tobacco smoking urge, intentions, and perceptions in daily, intermittent, and former smokers? Health Commun 31:129–138. https://doi.org/10.1080/10410236.2014.993496
McMillen RC, Gottlieb MA, Shaefer RMW et al (2015) Trends in electronic cigarette use among U.S. adults: use is increasing in both smokers and nonsmokers. Nicotine Tob Res 17:1195–1202. https://doi.org/10.1093/ntr/ntu213
Mickle T (2015) Take a deep breath if you want to try competitive vaping. Wall Str J. https://www.wsj.com/articles/take-a-deep-breath-if-you-want-to-try-competitive-vaping-1429646394. Accessed 16 Feb 2018
Pepper JK, Emery SL, Ribisl KM, Southwell BG, Brewer NT (2014) Effects of advertisements on smokers’ interest in trying e-cigarettes: the roles of product comparison and visual cues. Tob Control 23:iii31–iii36. https://doi.org/10.1136/tobaccocontrol-2014-051718
Pierce JP, Sargent JD, Portnoy DB, White M, Noble M, Kealey S, Borek N, Carusi C, Choi K, Green VR, Kaufman AR, Leas E, Lewis MJ, Margolis KA, Messer K, Shi Y, Silveira ML, Snyder K, Stanton CA, Tanski SE, Bansal-Travers M, Trinidad D, Hyland A (2018) Association between receptivity to tobacco advertising and progression to tobacco use in youth and young adults in the PATH study. JAMA Pediatr 172:444–451. https://doi.org/10.1001/jamapediatrics.2017.5756
Piñeiro B, Correa JB, Simmons VN, Harrell PT, Menzie NS, Unrod M, Meltzer LR, Brandon TH (2016) Gender differences in use and expectancies of e-cigarettes: online survey results. Addict Behav 52:91–97. https://doi.org/10.1016/J.ADDBEH.2015.09.006
Rowell TR, Tarran R (2015) Will chronic e-cigarette use cause lung disease? Am J Physiol Lung Cell Mol Physiol 309:L1398–L1409. https://doi.org/10.1152/ajplung.00272.2015
Rubinstein ML, Delucchi K, Benowitz NL, Ramo DE (2018) Adolescent exposure to toxic volatile organic chemicals from E-cigarettes. Pediatrics 141:e20173557. https://doi.org/10.1542/peds.2017-3557
Schneider S, Diehl K (2016) Vaping as a catalyst for smoking? An initial model on the initiation of electronic cigarette use and the transition to tobacco smoking among adolescents. Nicotine Tob Res 18:647–653. https://doi.org/10.1093/ntr/ntv193
Schoenborn CA, Clarke TC (2017) QuickStats: percentage of adults who ever used an E-cigarette and percentage who currently use E-cigarettes, by age group. National Health Interview Survey, United States, p 2016
Sobell LC, Sobell MB (1992) Timeline follow-back. In: Litten RZ, Allen JP (eds) Measuring alcohol consumption. Humana Press, Totowa, pp 41–72
Soneji S, Barrington-Trimis JL, Wills TA, Leventhal AM, Unger JB, Gibson LA, Yang JW, Primack BA, Andrews JA, Miech RA, Spindle TR, Dick DM, Eissenberg T, Hornik RC, Dang R, Sargent JD (2017) Association between initial use of e-cigarettes and subsequent cigarette smoking among adolescents and young adults. JAMA Pediatr 171:788–797. https://doi.org/10.1001/jamapediatrics.2017.1488
Soneji SS, Sung H-Y, Primack BA, Pierce JP, Sargent JD (2018) Quantifying population-level health benefits and harms of e-cigarette use in the United States. PLoS One 13:e0193328. https://doi.org/10.1371/journal.pone.0193328
Spielberger CD, Gorsuch R, Lushene RE et al (1983) Manual for the State-Trait Anxiety Inventory. Consulting Psychologists Press, Inc., Palo Alto
Stratton K, Kwan LY, Eaton DL (eds) (2018) Public health consequences of E-cigarettes. National Academies Press, Washington, D.C.
Tse WS, Bond AJ (2001) Development and validation of the two-dimensional social interaction scale (2DSIS). Psychiatry Res 103:249–260. https://doi.org/10.1016/S0165-1781(01)00271-2
Vardavas CI, Filippidis FT, Agaku IT (2015) Determinants and prevalence of e-cigarette use throughout the European union: a secondary analysis of 26 566 youth and adults from 27 countries. Tob Control 24:442–448. https://doi.org/10.1136/tobaccocontrol-2013-051394
Villanti AC, Rath JM, Williams VF, Pearson JL, Richardson A, Abrams DB, Niaura RS, Vallone DM (2016) Impact of exposure to electronic cigarette advertising on susceptibility and trial of electronic cigarettes and cigarettes in US young adults: a randomized controlled trial. Nicotine Tob Res 18:1331–1339. https://doi.org/10.1093/ntr/ntv235
Wagener TL, Floyd EL, Stepanov I, Driskill LM, Frank SG, Meier E, Leavens EL, Tackett AP, Molina N, Queimado L (2017) Have combustible cigarettes met their match? The nicotine delivery profiles and harmful constituent exposures of second-generation and third-generation electronic cigarette users. Tob Control 26:e23–e28. https://doi.org/10.1136/tobaccocontrol-2016-053041
Wechsler D (1956) Manual for the Wechsler Adult Intelligence Scale. Psychological Corporation, New York
West R, Ussher M (2010) Is the ten-item Questionnaire of Smoking Urges (QSU-brief) more sensitive to abstinence than shorter craving measures? Psychopharmacology 208:427–432. https://doi.org/10.1007/s00213-009-1742-x
Yingst JM, Veldheer S, Hrabovsky S, Nichols TT, Wilson SJ, Foulds J (2015) Factors associated with electronic cigarette users’ device preferences and transition from first generation to advanced generation devices. Nicotine Tob Res 17:1242–1246. https://doi.org/10.1093/ntr/ntv052
Acknowledgements
Appreciation is extended to Patrick McNamara for protocol assistance, Luke Newell, Eric Giger, and Jennan Qato for research support, and Tony Pace, Pace Engineering Concepts, Milwaukee, WI, for e-liquid preparation and quality control.
Funding
This study was supported by R56-DA044210, T32-DA043469, and Department of Psychiatry and Behavioral Neuroscience Research Faculty Fund.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
The study was fully approved by the University of Chicago Institutional Review Board.
Conflict of interest
Dr. King has received funding from the National Institutes of Health and from Pfizer, Inc., has provided past consultation to Lundbeck and the US Food and Drug Administration, and has served on a health advisory board to Pfizer Inc. Dr. Cao has provided consultation to the US Food and Drug Administration. AV and MH have no conflicts of interest to declare.
Additional information
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Electronic supplementary material
ESM 1
(DOCX 39 kb)
Rights and permissions
About this article
Cite this article
Vena, A., Howe, M., Cao, D. et al. The role of E-liquid vegetable glycerin and exhaled aerosol on cue reactivity to tank-based electronic nicotine delivery systems (ENDS). Psychopharmacology 236, 2083–2092 (2019). https://doi.org/10.1007/s00213-019-05202-6
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00213-019-05202-6