E-cigarettes use prior to smoking combustible cigarettes among dual users: The roles of social anxiety and E-cigarette outcome expectancies.

Introduction:
This text provides an analysis of a study examining the relationship between social anxiety and e-cigarette use among dual users. The study aims to understand the factors that contribute to the transition from exclusive e-cigarette use to dual use of e-cigarettes and combustible cigarettes. The study also explores the potential mediation effect of negative reinforcement expectancies regarding e-cigarette use.

Key Points:

* The study sample consisted of 226 current dual users (use both e-cigarettes and combustible cigarettes).
* Most dual users (67.3%) reported using e-cigarettes before smoking combustible cigarettes.
* E-cigarette cigarette initiators reported statistically significantly greater negative reinforcement and weight control expectancies than combustible cigarette initiators.
* E-cigarette cigarette initiators reported more social anxiety than combustible cigarette initiators, even after controlling for demographic variables, tobacco-related variables, alcohol problem severity, and distress.
* Social anxiety was indirectly related to initiation type via negative reinforcement expectancies and weight control expectancies.
* This is the first known study to identify that among dual users, social anxiety was associated with e-cigarette initiation via negative reinforcement and weight control expectancies.
* Findings suggest that socially anxious young adults may be especially vulnerable to transitioning from exclusive e-cigarette use to dual use at least partially due to expectations regarding e-cigarette's ability to manage negative affect and/or weight.

Main Message:
The study highlights the importance of considering social anxiety in understanding e-cigarette use among young people. The findings suggest that socially anxious individuals may be more likely to transition from exclusive e-cigarette use to dual use with combustible cigarettes due to expectations regarding e-cigarette's ability to manage negative affect and weight. These results have implications for developing and refining interventions aimed at decreasing combustible smoking among vulnerable populations.

Buckner JD, Abarno CN, Zvolensky MJ, et al. E-cigarettes use prior to smoking combustible cigarettes among dual users: The roles of social anxiety and E-cigarette outcome expectancies. Addictive behaviors. 2021;117:106854. doi:10.1016/j.addbeh.2021.106854