Expectancies for and Pleasure from Simultaneous Alcohol and E-Cigarette Use among Young Adults

Wide-Ranging Responses to Temporary Abstinence Challenges Among UK-Based Heavier Drinkers: A Three-Wave Longitudinal Interpretative Phenomenological Analysis

Temporary abstinence challenges (TACs) encouraging people to abstain from alcohol for typically 1 month time periods have acquired considerable popularity. TACs may promote longer-term reductions in alcohol consumption, but it is unclear how TACs influence behavior changes and whether positive changes are held among adults identifiable as relatively heavy drinkers. Drawing on a UK-based sample of six heavier drinkers, we measured self-reported alcohol consumption and drink-refusal self-efficacy and conducted interviews at three timepoints: pre-TAC participation (T1), and immediately following (T2) and 6 months post-TAC (T3) participation. Using longitudinal interpretative phenomenological analysis, an analytic technique for understanding change over time, and via integration with quantitative self-report measures, we identified three patterns of evidence about longer-term change (or not) in alcohol use linked to TAC participation: "mainly clear change," "unclear/complicated change," and "no change or limited change," each with narrative illustrations from two participants. We found evidence of greater reflection about alcohol consumption at T2 and lower levels of T3 alcohol intake among four of six participants. For some, TAC participation revealed downsides of drinking, and linked participation to reductions in their alcohol consumption. However, other interviews suggested ambivalence about and "backfire effects" associated with TAC participation, in that positives of alcohol consumption were highlighted, with apparently linked negligible changes in consumption practices. Research implications suggest that inoculation against renewed alcohol appreciation may strengthen TAC campaign successes. Future research must test the tenability of our identified trajectories and explore, experimentally, drinking trajectories among registered versus unregistered TAC participants.

Cross-sectional analysis of e-cigarettes, combustible tobacco and their dual use with binge drinking among college students in the USA

Background

Tobacco use is a long-standing epidemic that has caused millions of premature deaths. Electronic cigarette use is rising among young adults, yet few studies have included combustible tobacco, e-cigarettes and their dual use in an analysis of binge drinking among college students. This study aims to calculate the associations between these three forms of tobacco use and binge drinking among college students.

Methods

This cross-sectional study used data from 332 721 college students from the American College Health Association-National College Health Assessment survey. Tobacco use was organised into four groups: no tobacco use, e-cigarette use only, combustible tobacco use only and dual use of e-cigarettes and combustible tobacco. Binge drinking was a binary indication of whether students had engaged in binge drinking in the last 2 weeks. Multiple logistic regression was employed to examine the relationship between tobacco use and binge drinking, adjusting for demographic factors and constructs of the integrated behavioural model.

Results

Each tobacco use group had significantly higher odds of binge drinking compared with students who did not use tobacco. Students who engaged in dual tobacco use had significantly higher odds of binge drinking compared with exclusive combustible tobacco use (adjusted OR, aOR=2.41, 95% CI: 2.29, 2.53) and exclusive e-cigarette use (aOR=1.79, 95% CI: 1.71, 1.86).

Conclusion

The strong relationship between dual tobacco use and binge drinking among college students warrants further investigation into the aetiology and clinical manifestations of this emerging coupled substance use behaviour among the next generation of adults.

Day-level correlates of nicotine and cannabis vaping among young adults in the United States

Over the past two decades, vaping has increased in popularity among young adults. Yet, little is known about the daily activities or contexts associated with vaping behavior. The current study examined whether nicotine vaping, cannabis vaping, and dual-substance vaping (i.e., vaping both nicotine and cannabis) fluctuated in tandem with alcohol use and activities on a given day. Data came from the Monitoring the Future Vaping Supplement, a national sample of U.S. young adults. A subsample of people who vaped (N = 330 people) completed up to 14 daily surveys (N = 3686 days). Multilevel logistic regressions separated within- and between-person characteristics and controlled for combustible nicotine and cannabis use, day of the week, and demographic characteristics. Weights accounted for the complex survey design and attrition. Results demonstrated that nicotine vaping was more common on days when participants drank moderately or binge drank (compared to not drinking), used cigarettes, and spent more time at bars and parties than usual. Cannabis vaping on a given day was more likely on days when young adults drank moderately and spent more time at bars/parties. Likewise, moderate drinking, spending more time at bars/parties than usual, and spending less time on schoolwork than usual was associated with a higher likelihood of dual-substance vaping on a given day. Our findings highlight when young adults vape nicotine and cannabis, while also identifying proximal correlates of these behaviors to inform intervention and cessation efforts.

Smoking, vaping and drinking: A qualitative analysis of Aotearoa New Zealand young adults who tried e-cigarettes to stop smoking tobacco

BACKGROUND AND AIM

Social practices such as smoking-drinking co-use often go 'hand-in-hand', linked by the coordination of materials, skills and meanings. However, the experience of using e-cigarettes while drinking among people who smoke (and drink) remains underexplored. We used social practice theory to show how smoking, vaping and drinking intersect and to explain how vaping created two new social practices among people who tried e-cigarettes to stop smoking: 'vaping-drinking' co-use and 'smoking-vaping-drinking' poly-use.

METHODS

We conducted five in-depth interviews over 18-24 weeks during 2018-19, with each of nine Aotearoa New Zealand young adults aged 20-29 years. Participants smoked daily, did not regularly use e-cigarettes at entry and wished to try vaping to stop smoking. We analysed participants' reports of smoking or vaping while drinking using thematic analysis.

RESULTS

Individual participants reported both co-use and poly-use occasions throughout the study. Vaping-drinking co-use arose from practice 'replacement' processes, where vaping fully substituted smoking. Smoking-vaping-drinking poly-use arose from 'adjacency' processes where vaping complemented smoking. Participants used both processes flexibly over time, which required new skills in material, temporal, pleasure and social coordination to try to recreate valued meanings of comfort, security and communality associated with well-established smoking-drinking practices. Unsuccessful coordination attempts maintained smoking-drinking co-use.

CONCLUSION

Among Aotearoa New Zealand young adult smokers who want to use vaping to stop smoking, drinking occasions may help to maintain existing smoking-drinking practices and facilitate the development of vaping-drinking co-use and smoking-vaping-drinking poly-use practices, potentially prolonging individuals' exposure to smoking.