Cue Reactivity in Non-Smoking Electronic Cigarette Users

Electronic cigarettes (ECIGs) are among the most popular nicotine products in the United States, particularly among youth and young adults. Many individuals who use ECIGs report an interest in quitting or unsuccessful quit attempts. In addition to nicotine dependence, one factor that may contribute to continued ECIG use is an individual’s response to ECIG-related environmental stimuli, or cues. Existing research demonstrates that exposure to ECIG cues increases craving for ECIGs among cigarette smokers, including those without previous ECIG experience. The purpose of this study was to examine effects of ECIG cue exposure in experienced ECIG users with minimal smoking history, thus eliminating the potential confound of pre-existing nicotine dependence and cue reactivity from cigarettes. Experienced ECIG users (N = 34) who were never established cigarette smokers (≤ 100 cigarettes lifetime) completed two within-subject cue exposure conditions that differed only by pictorial cue type: ECIG or neutral. Participants experienced two bouts of cue exposure per session, completing subjective measures of ECIG craving and mood before and after each bout. After both cue exposures, participants completed hypothetical delay-discounting and behavioral economic tasks. Two different versions of these tasks were completed, with ECIG use quantified in either puffs or minutes of use. Mixed-effects models and paired-samples t-tests assessed effects of cue type on these outcomes. Ratings of desire to vape (Questionnaire on Vaping Urges-Brief Factor 1, ECIG Schuh-Stitzer) increased significantly from pre- to post-cue exposure for ECIG cues relative to neutral cues, p’s < .05. A similar pattern was observed for negative mood (Positive and Negative Affect Schedule), p = .005. ECIG cue exposure did not significantly affect ECIG delay discounting or increase demand for ECIGs, p’s > .05. Results are largely consistent with those reported for cigarette smokers. Findings may inform the regulation of ECIG product advertising, as exposure to ECIG-related cues may promote continued ECIG use.