Background: COVID-19 has caused health impacts and disruptions globally. Electronic cigarette (ECIG) users may face additional impacts. This study examined impacts of COVID-19 on ECIG users. Methods: Concept mapping, a mixed-methods approach, was used to identify COVID-19 impacts on adult ECIG users. ECIG users (n = 93) provided statements completing a prompt: “A specific way Coronavirus/COVID-19 has affected my vaping/e-cigarette use, my vaping/e-cigarette related purchasing, or other vaping/e-cigarette related behaviors or issues is…”. Participants generated 85 unique statements, sorted statements into groups of similar content and rated each statement on how true they were. Multidimensional scaling and hierarchical cluster analysis identified thematic clusters. Mean cluster ratings were compared between sample subgroups. Results: Ten clusters were identified: Stocking up and Bulk Purchasing, Challenges in Obtaining ECIG Supplies, Alternative Purchasing Procedures, Increased ECIG use, Disruption of Routine and ECIG Use, Efforts to Decrease ECIG Use, Improving ECIG Skills, COVID-19 Health Concerns, Perceptions of ECIG Use and COVID-19, and COVID-19 Protection. More dependent ECIG users and dual users of ECIGs and cigarettes rated clusters higher than less dependent ECIG users and non-dual users. Conclusions: ECIG users may experience or perceive they face additional COVID-19 impacts, such as increased exposure, financial burdens, stress, and health risks.

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In this article, we explore the context and determinants of pod-mod electronic cigarette (ECIG) use among college students aged 18 to 24 in the United States. We conducted semi-structured interviews with 55 students ( M age = 20 years, 56% female, 65% White) on three campuses in the Northwest, Midwest, and Southeast. We performed a thematic analysis. Students described ECIG use by peers, increased ECIG exposure and prevalence in college, and school-related stress as reasons for vaping. Pod-mod features such as convenience, design, easy concealment, and flavors made vaping more appealing. Negative aspects of vaping included addiction, cost, and possible health consequences. Most viewed vaping as a college behavior and intended to quit after graduation. Our results show that the college environment plays a major role in young adult ECIG use. These findings can inform the development of targeted interventions to prevent and control uptake of ECIGs by young adults.

Introduction Electronic cigarettes (ECIGs) heat a nicotine-containing liquid to produce an inhalable aerosol. ECIG power (wattage) and liquid nicotine concentration are two factors that predict nicotine emission rate (“flux”). These factors can vary greatly across devices and users. The purpose of this study was to examine ECIG device and liquid heterogeneity in “real world” settings and the association with predicted nicotine flux, nicotine yield, and total particulate matter (TPM) emissions. Methods Past 30-day ECIG users (n=84; mean age=23.8 years [SD=9.6]) reported device and liquid characteristics. Device power was measured via multimeter, device display screens, or obtained via labeling. Liquid nicotine concentration was obtained via labeling or through chemical analysis. Predicted nicotine flux, nicotine yield, and TPM associated with 10 four-second puffs were calculated for participants’ primary devices. Results Participants’ primary devices were box mods (42.9%), disposable vapes (20.2%), and pod mods (36.9%). Most participants (65.5%) reported not knowing their primary device wattage. Rebuildable/box mods had the greatest power range (11.1-120.0 watts); pod mod power also varied considerably (4.1-21.7 watts). Unlike device wattage, most participants (95.2%) reported knowing their liquid nicotine concentration, which ranged from 3.0-86.9 mg/ml (M=36.0, SD=29.3). Predicted nicotine flux varied greatly across products (range=12.0-160.1 μg/sec, M=85.6 μg/sec, SD=34.3). Box mods had the greatest variability in wattage and predicted nicotine flux, nicotine yield, and TPM yield. Conclusions ECIG device and liquid heterogeneity influences nicotine and other toxicant emissions. Better measurement of ECIG device and liquid characteristics is needed to understand nicotine and toxicant emissions and to inform regulatory policy. Implications Electronic cigarette device and liquid heterogeneity causes great variability in nicotine flux and toxicants emitted. These data demonstrate the need to examine device and liquid characteristics to develop empirically-informed, health-promoting regulatory policies. Policies may include setting product standards such that electronic cigarette products cannot 1) have nicotine fluxes much greater than that of a cigarette to decrease risk of dependence, 2) have nicotine fluxes that are very low and thus would have minimal appeal to cigarette smokers and may serve as starter products for youth or non-tobacco users, and 3) emit large amounts of particulate matter and other toxicants.