Whipped Cream, Whiskey, and Weight Loss: Exploring the Versatility of E-cigarette Use in Adolescents and Adults

E-cigarettes are gaining popularity among Americans of all ages (King et al., 2014). Research largely has focused on motivations for e-cigarette use that are driven by perceptions that vaping is less harmful than smoking cigarettes. Recently, research has identified motivations for vaping that are applicable to non-smokers. Of note, 13.5% of an online sample of adult e-cigarette users reported vaping to lose or control their weight (Morean & Wedel, 2017). The appeal of vaping to lose weight may disproportionately put individuals who have eating disorders at risk for vaping. Similar to cigarettes, most e-cigarettes contain e-liquid with nicotine, an appetite-suppressant that curbs cravings and increases daily calorie expenditure by approximately 200 calories (Chiolero et al. 2008). It also is possible that vaping serves as a behavioral distraction from hunger or a substitute for eating, similar to cigarettes (Kovacs et al., 2014). Further, e-cigarettes uniquely are available in many flavors that mimic high-calorie or high-fat foods (e.g., chocolate cake; caramel) yet contain no calories, a feature that may appeal to individuals with EDs. For the current study, I collected online data from 400 American adult e-cigarette users (200 with EDs) to determine whether rates of vaping to lose weight are elevated among individuals with EDs. Based on the cigarette smoking literature and on anecdotal evidence obtained from online eating disorder websites, I anticipate that more individuals with EDs will report vaping to lose weight than will individuals without EDs. Potential motives for vaping for weight loss subsequently will be examined

Prevalence and correlates of medical cannabis patients\u27 use of cannabis for recreational purposes

Background: Rates of legal medical cannabis (MC) use are increasing, but little is known about the prevalence and correlates of recreational cannabis (RC) use among medical users (MC/R). Methods: 348 MC users who resided in a state in which MC is legal and had medical authorization to use MC legally completed an anonymous survey in Spring 2017 (64.1% female, 82.8% White, mean age 33.03[±10.37] years). Rates of endorsing MC/R and the following potential correlates of MC/R were examined: the legal status of RC in participants\u27 states of residence, sex, age, race, primary medical condition, MC product(s) used, MC expectancies, features of MC sought out (e.g., high tetrahydrocannabinol [THC] content), and negative cannabis use consequences. Results: 55.5% of MC users engaged in MC/R. MC/R was associated with residing in a state in which RC is legal, being female, using MC for pain or mental health conditions, vaping MC concentrates, holding positive expectancies for combustible MC, and seeking out MC products with high THC concentrations. Preferring MC products with high cannabidiol (CBD) concentrations protected against MC/R. Conclusions: More than half of MC users endorsed MC/R, which is considerably higher than rates of misuse observed for other prescription medications. Findings raise concerns about circumvention of RC laws in states where RC remains illegal and could be used to inform MC regulatory efforts (e.g., reducing THC content, increasing CBD content). Findings also suggest that prevention/intervention efforts to reduce MC/R are needed, especially among high-risk populations of MC users (e.g., women, pain patients, psychiatric patients)

The Short Form Vaping Consequences Questionnaire: Psychometric Properties of a Measure of Vaping Expectancies For Use With Adult E-cigarette Users

Introduction: E-cigarettes are popular in the United States, but psychometrically sound measures of vaping beliefs and behaviors are lacking. METHODS: We evaluated the psychometrics of the Short-Form Vaping Consequences Questionnaire (S-VCQ), a modified version of the Short-Form Smoking Consequences Questionnaire that assesses expectancies for negative consequences, positive reinforcement, negative reinforcement, and appetite/weight control associated with vaping. Adult, past-month e-cigarette users completed an anonymous survey in Fall 2015 (N = 522, 50.4% female; 71.5% White; 34.10 [SD = 9.66] years). Psychometric analyses included confirmatory factor analysis, internal consistency, measurement invariance, t-tests, correlations, and test-criterion relationships with vaping outcomes. Results: The S-VCQ evidenced a four-factor latent structure (CFI = .95, RMSEA = .05, SRMR = .06), and subscales evidenced internal consistency (mean α = .89). S-VCQ scores were scalar invariant for sex and smoking status; women reported stronger appetite/weight control than men and dual cigarette/e-cigarette users (n = 309) reported stronger negative vaping consequences and negative reinforcement than non-smokers. Among dual users, vaping and smoking expectancies also were scalar invariant; dual users reported stronger positive reinforcement associated with vaping than smoking but stronger negative consequences, negative reinforcement, and appetite/weight control associated with smoking than vaping. Correlations indicated that vaping and smoking expectancies were related, yet distinct constructs. Univariate general linear models indicated that vaping frequency and dependence were associated with positive reinforcement (η2pηp2 = .02/.02), negative reinforcement (η2pηp2 = .02/.08), and appetite/weight control (η2pηp2 =.02/.02) from vaping. Conclusions: The S-VCQ evidences solid psychometrics as a measure of adult e-cigarette users’ vaping expectancies. Implications: The current study provides evidence for the reliability and validity of the Short Form Vaping Consequences Questionnaire, the first measure of vaping expectancies that has been validated for use with adult e-cigarette users. Results indicated that the S-VCQ comprises four subscales that evidenced internal consistency, scalar measurement invariance for important groups of interest, and test-criterion relationships with vaping outcomes. Researchers are encouraged to consider using this measure for assessing vaping expectancies in adult e-cigarette users

Positive Drinking Consequences Are Associated With Alcohol Use and Alcohol-Related Problems Among Veterans Seeking Treatment for Alcohol Use Disorder

Background: Military service is associated with increased rates of heavy drinking. Widely used clinical practices (e.g., motivational interviewing) indicate that addressing both negative and positive drinking consequences is essential to effective treatment. However, research on effectively assessing positive drinking consequences in a clinical population is absent. Aims: The current study (1) evaluated the utility of the Positive Drinking Consequences Questionnaire (PDCQ), a measure previously validated in an undergraduate sample, for use with treatment-seeking veterans, and (2) evaluated relationships between positive drinking consequences and alcohol expectancies, pre-treatment alcohol use, and alcohol-related problems. Method: Ninety-seven veterans seeking treatment for alcohol problems completed an anonymous survey (97.9% male; mean age = 49.76[11.40], 67.0% Caucasian). Results: The PDCQ evidenced a single factor latent structure and internal consistency (Cronbach\u27s alpha = .90). Positive drinking consequences and expectancies were related yet distinct constructs. After controlling for demographic factors, experiencing more positive drinking consequences at program intake was associated with heavier pretreatment drinking ((2)(p) = .10, p = .003) and alcohol-related problems ((2)(p) = .18, p \u3c .001). Further, PDCQ scores evidenced incremental validity in accounting for pretreatment alcohol use ((2)(p) = .12, p = .002) and alcohol-related problems ((2)(p) = .11, p = .003) when expectancies also were included in the model. Conclusion: Positive drinking consequences are assessed reliably by the PDCQ in a clinical sample and appear to play an important role in the drinking behavior of veterans seeking alcohol treatment

Electronic cigarette use among individuals with a self-reported eating disorder diagnosis

Objective: The primary study aim was to examine whether rates of using e‐cigarettes (“vaping”) to lose weight are elevated among American adults who self‐report having an eating disorder (ED). Method: Adult vapers who reported either currently having an ED (n = 178; 72.5% women, 83.7% White, mean age 33.26 [SD = 8.35] years) or no ED history (n = 433; 54.7% women, 83.4% White, 35.98 [SD = 11.71] years) completed an anonymous survey. Results: Relative to participants reporting no ED history, participants who reported currently having an ED were more likely to report vaping to lose/control weight, because it can be concealed from others, and due to the availability of sweet flavors. Participants reporting a current ED also were more likely to vape daily, to use higher nicotine concentrations, and to vape to relieve negative affect than were individuals without EDs. Discussion: Individuals who self‐reported currently having an ED endorsed vaping motives that are consistent with eating pathology (e.g., substance‐induced weight loss, hiding compensatory behaviors from others). They also were more likely to vape daily and to use higher nicotine concentrations, raising health concerns. The findings suggest that treatment providers should screen for e‐cigarette use in clients seeking ED treatment

Vaping to lose weight: Predictors of adult e-cigarette use for weight loss or control

Introduction: Some traditional cigarette smokers are motivated to smoke to lose weight or control their weight. The current study evaluated whether a subset of adult e-cigarette users reported vaping to lose or control their weight and examined potential predictors of vaping for weight management. Methods: Adult e-cigarette users (n = 459) who reported wanting to lose weight or maintain their weight completed an anonymous online survey. Participants reported on demographics, vaping frequency, e-cigarette nicotine content, cigarette smoking status, preferred e-cigarette/e-liquid flavors, current weight status (i.e., overweight, underweight), use of dieting strategies associated with anorexia and bulimia, lifetime history of binge eating, self-discipline, and impulse control. Binary logistic regression was used to examine whether vaping for weight loss/control was associated with the aforementioned variables. Results: Participants who reported vaping for weight loss/control (13.5%) were more likely to vape frequently (adjOR = 1.15; 95% CI [1.00, 1.31]); be overweight (adjOR = 2.80; [1.33, 5.90]); restrict calories (adjOR = 2.23; [1.13, 4.42]); have poor impulse cantrol (adjOR = 0.59; [0.41, 0.86]); and prefer coffee-(adjOR = 2.92; [1.47, 5.80]) or vanilla-flavored e-liquid (adjOR = 7.44; [1.56, 36.08]). Conclusions: A subset of adult e-cigarette users reported vaping for weight loss/control, raising concerns about expanded, scientifically unsubstantiated uses of e-cigarettes. Identifying where individuals obtain information about vaping for weight loss (e.g., e-cigarette ads, Internet) and whether weight-related motives promote e-cigarette initiation among e-cigarette naïve individuals is important to informing regulatory efforts. Further research also is needed to better understand the link between e-liquid flavors and weight loss motivations

Predictors of quickly progressing from initiating alcohol use to engaging in binge drinking among adolescents

Background: A short delay to first intoxication confers alcohol-related risk, but risk factors for a short delay have yet to be examined. Methods: 230 high school students (55.7% male; age 16.52 [1.19] years; 70.9% White) were surveyed about alcohol use. We examined whether sex, race, parental history of alcohol problems, age of onset, type of alcohol consumed, drinking company, and subjective response to alcohol were associated with 1) delay to first binge episode and 2) binge drinking status (i.e., never bingers, individuals who binge drank on their first drinking occasion, and individuals who binge drank at a later date). Finally, we examined whether first-occasion bingers reported heavier drinking and alcohol-related problems than later-occasion and never bingers. Results: Overall, a shorter delay was associated with being male an older age of onset, and, during one\u27s first drinking experience, consuming liquor, drinking with friends or alone, and experiencing high arousal negative alcohol effects. First-occasion bingers were more likely to be male, consume liquor, and experience stronger high arousal positive and negative alcohol effects than never bingers and to have a later age of onset, experience stronger high arousal negative, and weaker low arousal negative alcohol effects than later-occasion bingers. First-occasion bingers also reported heavier current drinking and more alcohol-related problems. Conclusions: Characteristics of underage drinkers that confer risk for a shorter delay and first-occasion binging may provide fruitful targets for intervention, as efforts to delay binge drinking may mitigate alcohol-related risk associated with underage alcohol use

Predictors of quickly progressing from initiating alcohol use to engaging in binge drinking among adolescents

Background: A short delay to first intoxication confers alcohol-related risk, but risk factors for a short delay have yet to be examined. Methods: 230 high school students (55.7% male; age 16.52 [1.19] years; 70.9% White) were surveyed about alcohol use. We examined whether sex, race, parental history of alcohol problems, age of onset, type of alcohol consumed, drinking company, and subjective response to alcohol were associated with 1) delay to first binge episode and 2) binge drinking status (i.e., never bingers, individuals who binge drank on their first drinking occasion, and individuals who binge drank at a later date). Finally, we examined whether first-occasion bingers reported heavier drinking and alcohol-related problems than later-occasion and never bingers. Results: Overall, a shorter delay was associated with being male an older age of onset, and, during one's first drinking experience, consuming liquor, drinking with friends or alone, and experiencing high arousal negative alcohol effects. First-occasion bingers were more likely to be male, consume liquor, and experience stronger high arousal positive and negative alcohol effects than never bingers and to have a later age of onset, experience stronger high arousal negative, and weaker low arousal negative alcohol effects than later-occasion bingers. First-occasion bingers also reported heavier current drinking and more alcohol-related problems. Conclusions: Characteristics of underage drinkers that confer risk for a shorter delay and first-occasion binging may provide fruitful targets for intervention, as efforts to delay binge drinking may mitigate alcohol-related risk associated with underage alcohol use. Keywords: Age of onset, Intoxication, Binge drinking, Delay to intoxication, Adolescent, Adolescenc