E-cigarette use among women of reproductive age: Impulsivity, cigarette smoking status, and other risk factors

Abstract

Introduction The study aim was to examine impulsivity and other risk factors for e-cigarette use among women of reproductive age comparing current daily cigarette smokers to never cigarette smokers. Women of reproductive age are of special interest because of the additional risk that tobacco and nicotine use represents should they become pregnant. Method Survey data were collected anonymously online using Amazon Mechanical Turk in 2014. Participants were 800 women ages 24–44 years from the US. Half (n = 400) reported current, daily smoking and half (n = 400) reported smoking less than 100 cigarettes lifetime. Participants completed questionnaires regarding sociodemographics, tobacco/nicotine use, and impulsivity (i.e., delay discounting & Barratt Impulsiveness Scale). Predictors of smoking and e-cigarette use were examined using logistic regression. Results Daily cigarette smoking was associated with greater impulsivity, lower education, past illegal drug use, and White race/ethnicity. E-cigarette use in the overall sample was associated with being a cigarette smoker and greater education. E-cigarette use among current smokers was associated with increased nicotine dependence and quitting smoking; among never smokers it was associated with greater impulsivity and illegal drug use. E-cigarette use was associated with hookah use, and for never smokers only with use of cigars and other nicotine products. Conclusions E-cigarette use among women of reproductive age varies by smoking status, with use among current smokers reflecting attempts to quit smoking whereas among non-smokers use may be a marker of a more impulsive repertoire that includes greater use of alternative tobacco products and illegal drugs.

Some Recent Developments on Financial Incentives for Smoking Cessation Among Pregnant and Newly Postpartum Women

“…Delay discounting of monetary rewards is a predictor of becoming a smoker among women of reproductive age [44] and moderated spontaneous quitting upon learning of pregnancy among lighter although not heavier smokers [45]. …”

Tobacco and nicotine delivery product use in a national sample of pregnant women

“…On the other hand, the fact that nearly one third of current tobacco cigarette smokers also use e-cigarettes, a product for which nicotine levels and nicotine-related impurities have been shown to vary across brands (England et al, 2015), may be of concern if it results in a greater level of nicotine exposure during pregnancy. Alternatively, if e-cigarette use among pregnant smokers signals interest in smoking cessation, this could be leveraged to reduce the risk of nicotine exposure in this group (Chivers et al, 2016). However, considering that a higher proportion of current tobacco cigarette smokers were former e-cigarette users (44.5%) than current e-cigarette users (28.5%) whether pregnant smokers use e-cigarettes to reduce or quit smoking is unclear.…”

“…Regarding internalizing disorders, depressive symptomatology is a well-established risk factor for tobacco use across the lifespan (Audrain-McGovern et al, 2009). Regarding externalizing disorders, the symptoms assessed on this subscale can be conceptualized as reflecting impulsivity, which is associated with cigarette smoking in both pregnant women (White, Redner, Skelly, & Higgins, 2014) and non-pregnant women of reproductive age (Chivers, Hand, Priest, & Higgins, 2016). On each subscale, participants earned one point for each item that they endorsed experiencing within the past year (range = 0–4 for internalizing and 0–5 for externalizing).…”

Electronic Cigarette Use among Current Smokers: A Pilot Qualitative Study

“…4 A survey study among women of reproductive age revealed that whereas impulsivity predicted e-cigarette use among never smokers, intention to quit smoking in the next 30 days and exhibiting higher nicotine dependence were important factors for e-cigarette use among current smokers. 4 A study of British smokers who had used e-cigarettes showed that initiation of e-cigarette use was influenced by social and psychological factors, such as using e-cigarettes with friends and family and the belief that e-cigarettes were less harmful than combustible cigarettes. 5 …”