Cue salience of the use of an electronic nicotine delivery system (ENDS) device marketed to women

Abstract

Introduction-Passive exposure to the use of electronic nicotine delivery systems (ENDS or ecigarettes) has been shown to generalize as a smoking cue. As young adult women in particular are increasingly targeted by ENDS distributors, the present study examined whether passive exposure to the use of a female-marketed ENDS product selectively enhanced smoking urge, cigarette and e-cigarette desire, and smoking behavior among women (vs men) smokers.Methods-Using a mixed design, young adult smokers (n=64; mean age 28.2 yrs; ≥5 cigarettes/ day) observed a study confederate drink bottled water (control cue) and then vape a femalemarketed tank-based ENDS (active cue). Main measures were the Brief Questionnaire of Smoking Urges (BQSU) and visual analog scales (VAS) for cigarette and e-cigarette desire pre-and post-cue exposure, followed by a smoking latency task.Results-Compared to the control cue, the female-marketed ENDS cue increased smoking urge and desire for cigarettes and e-cigarettes to a similar extent in women and men. It also affected subsequent smoking behavior similarly between the sexes, with 68% of men and 58% of women opting to smoke (vs. obtaining monetary reinforcers).Conclusions-Both women and men were sensitive to the use of the female-marketed ENDS as a smoking cue. Consistent with prior work by our group, findings demonstrate the cue salience of ENDS, which may be attributable to the aspects of vaping that resemble traditional smoking (e.g. hand-to-mouth and inhalation and exhalation behaviors).

Cue Reactivity to Electronic Cigarettes: A Systematic Review

“…79 , 82 In regards to nicotine content, only 10 studies reported the ENDS nicotine levels used in their experiments. 64 , 69 - 72 , 74 , 77 , 79 - 81 E-liquids nicotine content ranged from 0 to 59 mg/ml (salt). Further information about ENDS types and nicotine levels used in the reviewed studies, including related outcomes, is presented in the sub-sections below and in Table 1 .…”

“…Overall, the reviewed studies were carried out between 2012 and 2020 and most of them used for their experiments, first- and second-generation ENDS. Only two studies used exclusively third generation, 71 , 72 and one study reported using fourth generation ENDS (JUUL) as a cue. Thus, two studies 65 , 66 directly compared first and third generation ENDS and their respective effects on craving.…”

“…No differences were found; both generations elicited craving to a similar extent. Comparing the results from studies that used exclusively first, 69 , 73 , 77 , 80 , 85 second 74 , 76 , 81 or third 71 , 72 generation ENDS, the only two studies 69 , 85 that did not find cue reactivity used first generation devices. At the same time, two other studies using first generation devices did find an effect.…”

“…Smoking latency, which relates to the participant’s ability to abstain from smoking tobacco cigarettes (measured in time) versus obtaining money as a reward, was determined in five studies. 70 , 71 , 74 , 78 , 79 In studies developed by Vena et al 70 , 71 the majority of participants chose to smoke over the money compensation, and Dowd and Tiffany 78 reported that participants spent more money to get cigarettes than ENDS. Additional secondary outcomes investigated in selected reviewed studies are presented next, including significant results on analyses: urge to vape, 66 , 69 urge to smoke, 70 , 85 intention to quit smoking or remain abstinent from smoking, 66 , 67 desire to smoke and vape, 66 self-efficacy (for smoking cessation and continued abstinence), 67 intentions to smoke or vape, intentions to buy ENDS and traditional cigarettes.…”

“…In addition, 18 studies [64][65][66][67][69][70][71][72][73][74][75][76][77][78][79][80][81][82] informed about the type (generation or commercial brand) of ENDS used in their experiments as cues (e.g., in person use or visualisation, in videos, advertisement, or printed ads) (Table 1). Moreover, ENDS were used either as a unique active cue or compared with other ENDS generations or tobacco cigarette cues.…”