Motivations for E-cigarette use and associations with vaping frequency and smoking abstinence among adults who smoke cigarettes in the United States.

Abstract

In observational studies, vaping daily is positively associated with cigarette smoking abstinence, while non-daily vaping is associated with less smoking abstinence (versus no e-cigarette use). It remains unknown whether cigarette smokers who vape daily have different motivations for using e-cigarettes than those who vape non-daily. Using latent class analysis and 10 self-reported reasons for vaping, we identified sub-groups of participants based on vaping motivations among 1544 adult (≥18 y) dual users of e-cigarettes and cigarettes at wave 4 of the Population Assessment of Tobacco and Health (2016-2018). We examined the association of motivation sub-groups with vaping frequency at wave 4, and subsequent cigarette smoking abstinence at wave 5 (2018-2019). Additional analyses examined the association of vaping frequency with smoking abstinence before and after adjustment for motivation sub-groups. Four distinct sub-groups of e-cigarette users emerged, including 54 % of participants who were "Vaping Enthusiasts", 20 % who vaped for "Convenience and Social Acceptability", 10 % classified as "Experimenters", and 16 % who vaped for "Quitting Smoking and Harm Reduction." The Convenience and Social Acceptability sub-group were less likely than "Vaping Enthusiasts" (AOR=0.29, 95 %CI[0.20-0.42]) and "Quitting Smoking and Harm Reduction" (AOR=0.41, 95 %CI[0.24-0.71]) classes to vape daily (versus non-daily). Sub-groups were not associated with smoking abstinence after one year. Adjustment for motivation sub-groups did not attenuate a positive association of daily vaping with smoking abstinence. Cigarette smokers who vaped for convenience and social acceptability were less frequent e-cigarette users than those with other vaping motivations. Vaping motivations were not associated with subsequent smoking abstinence.