A recent study showed that approximately 10% of college students have used electronic cigarettes (e-cigarettes) within the past 30 days. Among these students, 80% also reported alcohol consumption in the past 30 days. Many college students also co-use alcohol and e-cigarettes which can lead to a variety of adverse effects including increased risk of addiction and cravings for each substance. Simultaneous use of these substances has also been associated with physical and mental health issues. This study uses ecological momentary assessment (EMA) to evaluate co-use of alcohol and e-cigarettes in real time.
The study’s sample consisted of 686 college students who reported using e-cigarettes from three universities in the US. Students downloaded a smartphone app that assessed e-cigarette use, polysubstance use, positive and negative affect, e-cigarette craving, and physiological sensation (buzzed/dizzy) five times a day for 7 days. Participants also completed a baseline survey that included scales assessing e-cigarette dependence, alcohol problems, chronic bronchitis symptoms, and past semester GPA. Data was analyzed using two- sample t tests, Chi-square tests, and generalized linear mixed models (GLMM).
Results of the data analysis showed that frequent drinkers tended to use a higher concentration level of nicotine, use e-cigarettes alone less frequently, spend more money on e-liquid/cartridge, and had a higher level of e-cigarette dependence. Frequent drinkers also had higher levels of respiratory symptomatology. Among frequent drinkers, higher alcohol quantity was associated with higher e-cigarette quantity and with each additional drink consumed the number of e-cigarette puffs was expected to increase by 4%. In addition, alcohol and e-cigarette use increased levels of positive affect, physiological sensation, and cravings for e-cigarettes. None of the interactions between e-cigarette and alcohol use were found to be significant.
Takeaway: Frequent alcohol and e-cigarette co-use may lead to more high-risk behaviors, dependence symptoms, and respiratory symptoms among college students.