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Although electronic cigarette (e-cigarette) use has increased among adults in the United States, there is still little knowledge of factors that may influence e-cigarette use or beliefs about use. Prior research suggests that health literacy plays an important role in e-cigarette beliefs, including perceived benefits and risks of e-cigarette use, as well as e-cigarette dependence. Yet, limited work has examined risk factors of poor e-cigarette health literacy. From a biopsychological perspective, sex and pain severity represent two constructs that may impact e-cigarette health literacy. To date, however, no research has investigated differences in e-cigarette health literacy across pain, sex, or their interrelation. Thus, the present study was conducted to evaluate the interactive effect of pain severity and sex on e-cigarette health literacy. Participants included 319 current, adult e-cigarette users (60.5% female, Mage = 36.82 years, SD = 10.62). Findings supported a significant pain by sex interaction, such that pain related to e-cigarette health literacy among women ( b = .10, SE = .03, P < .001), but not men ( b = .01, SE = .03, P = .60). The present findings suggest that pain may uniquely impact the degree to which women, but not men, seek and understand information on e-cigarettes.

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Background and ObjectivesDespite greater rates of cannabis use among those that smoke combustible cigarettes, it is currently unknown whether cannabis use is related to e‐cigarette dependence or maladaptive beliefs about combustible cigarettes. Therefore, the current study sought to identify whether adult dual users of combustible and e‐cigarettes (ie, dual users) who also used cannabis differed from dual users who did not use cannabis on e‐cigarette dependence severity, perceived barriers to quitting, and perception of risks and of benefits of e‐cigarettes.MethodsParticipants were 414 current dual users (48.3% female, Mage = 35.1 years, SD = 10.0), 51% of whom were current cannabis users.ResultsDual users who reported current cannabis use evidenced more severe dependence on e‐cigarettes (ηp2 = 0.12), higher perceived barriers for quitting e‐cigarettes (ηp2 = 0.06), and greater perceived benefits (ηp2 = 0.03) as well as higher perception of risks (ηp2 = 0.03) for using e‐cigarettes. The results were evident after controlling for the variance associated with sex, age, education, income, and frequency of e‐cigarette use.Discussion and ConclusionsOverall, the current findings suggest cannabis may be an important type of substance use behavior that is relevant to e‐cigarette dependence and beliefs about use and quitting among adult dual users.Scientific SignificanceThe present data extend current understanding of dual users by contextualizing cannabis use within e‐cigarette and combustible cigarette use behaviors and highlight a potential substance use behavior that may be targetable in the framework of nicotine cessation. (Am J Addict 2020;00:00–00)