E-Cigarette Use, Dependence, and The Use of Protective Behavioral Strategies: A Path Model

Background: E-cigarettes have become a popular form of nicotine use. The use of protective behavioral strategies (PBS) has been associated with less use of alcohol and fewer alcohol-related consequences. However, the relationship between PBS and e-cigarette-related outcomes have been understudied. Guided by the Theory of Planned Behavior, we examined the associations between the use of PBS for vaping (PBSV), perceived behavioral control over using PBSV, the frequency of past month e-cigarette use, and e-cigarette dependence. Methods: Adults who reported using an e-cigarette for at least once a day were recruited and completed an online survey (N = 298). Results: The path analytic model with e-cigarette dependence as the outcome fit the data well. Greater perceived behavioral control was associated with greater use of PBSV, greater use of PBSV was associated with less e-cigarette use, and less e-cigarette use was associated with less dependence. Conclusions: Our findings contribute to understanding e-cigarette use harm reduction strategies in the context of confidence over using PBS, frequency of e-cigarette use, and e-cigarette dependence. Results highlight the need for continued research and exploration of the potential clinical and public health benefits of PBSV as an intervention for e-cigarette use behaviors and dependence.