Are young adults’ expectancies for alternative nicotine and tobacco products predictors of their use of e-cigarettes and hookah? With the increasing prevalence of these alternative nicotine and tobacco products (ANTPs) and the little research on the use of such products, one study set out to determine the relationship between ANTP expectancies and usage among young adults. Outcome expectancies are an individual’s beliefs regarding consequences of substance use based on their experiences and observations of the consequences of specific substance using behaviors. This cognitive process has been extensively researched and found to be associated with the use of multiple substances such as tobacco, but there is little research examining its predictive relationship to ANTP use. This study enrolled 377 young adults aged 18-24 that have smoked cigarettes monthly for the previous six months, but have never smoked daily for one month. ANTP expectancies were measured by questions related to products’ harmfulness to health, affect regulation (e.g. stress relief), social facilitation, and substitution for cigarettes (e.g. improves coping with cravings). Of the participants surveyed regarding their behaviors in the past 14 days, 33.4% reported hookah use, 34% reported e-cigarette use, and 18% reported using both. More positive expectancies predicted more frequent use of both e-cigarettes and hookah. Participants with more expectation that the ANTPs would improve affect, socialization, or cigarette craving relief were more likely to use them in the past two weeks. Interestingly, expectancies for health consequences were not associated with ANTP use.
Take away: These findings indicate that ANTP expectancies do predict whether or not a young adult cigarette smoker will also use these products. This study suggests a need for prevention and intervention programs tailored specifically to ANTP use. Also, because affect regulation was the most consistent predictor of ANTP use, affect regulation components are strongly needed in intervention programs.