Real-Time Evaluation of Craving, Withdrawal, and Respiratory Symptoms Among Adolescents and Young Adults Who Use...

A growing body of work has identified short-term harms of e-cigarette use that may be indicative of long-term harm. Ecological momentary assessment (EMA) is a methodology that can contribute to these efforts, as it lends itself to capturing moment-to-moment changes in symptoms as people go about their natural environments. This study leveraged EMA to assess the correspondence between instances of e-cigarette use and changes in self-reported health.

Our analytical sample comprised 173 youth living in Ohio (ages 15-24). At enrollment, 60 had used e-cigarettes in the last 3 months, and 113 had never used e-cigarettes. All participants completed a baseline survey. Then, for 14 d, participants were prompted at 3 random times/d to complete EMA surveys; for all participants, these assessed e-cigarette use, self-reported lung health, e-cigarette craving, and withdrawal symptoms.

Among youth enrolled for e-cigarette use, an average of 50.8% of EMAs reported an instance of e-cigarette use. Multilevel models (MLMs) indicated that instances of e-cigarette use were associated with worse self-reported lung health (point estimate: -0.143, 95% CI: -0.203, -0.083 on a 1-5 Likert-type scale). Using an e-cigarette was also associated with: instances of coughing; reduced e-cigarette craving; and feeling less drowsy, anxious, and irritable.

Although infrequent, periods of poor respiratory symptoms were associated with recent instances of youth e-cigarette use. Instance of e-cigarette use were also associated with temporary reductions in craving and withdrawal. This study adds to emerging knowledge on e-cigarette harms by demonstrating associations at a granular level, across an ecologically valid context.