Electronic cigarette cue reactivity in exclusive electronic cigarette users

Exposure to electronic cigarette (ECIG) cues increases craving for ECIGs among people who smoke cigarettes, including those without prior ECIG use experience. This study aimed to examine the effects of ECIG cue exposure in individuals who use ECIGs regularly but have minimal smoking history (<100 cigarettes lifetime).

Participants (N = 42) attended two within-subjects conditions that differed by pictorial cue type: ECIG or neutral (water) cues. Each condition included two presentations of the condition-assigned cue type. Before and after each cue presentation, participants completed subjective measures of ECIG craving, anticipated relief from withdrawal, and mood. After the second cue presentation, participants completed ECIG delay discounting and behavioral economic tasks, with ECIG use quantified in puffs or in minutes of ECIG access. Linear mixed-effects regressions and paired-samples t-tests assessed the effects of cue type on these outcomes.

Ratings of ECIG craving and anticipation of relief from ECIG withdrawal 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 (p < .05). ECIG cues (versus neutral cues) also increased discounting of delayed minutes of ECIG access (p < .05) but not ECIG puffs.

This is the first study to demonstrate that ECIG cues increase ECIG craving and negative mood in individuals who vape but do not smoke cigarettes. Results have implications for restrictions on where vaping should be permitted.