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A Mixed Methods EMA Assessment of Cognition and Behavior among New ENDS Users

Principal Investigator: Jennifer Pearson

Funding Mechanism: National Institutes of Health- Grant

ID number: 1R21DA036472-01

Award Date: 9/30/2013

Institution: American Legacy Foundation

Electronic nicotine delivery systems (ENDS), also known as e-cigarettes, are the most prevalent of the emerging noncombustible products. Research suggests that African-American smokers are less likely than White smokers to try or use ENDS, perhaps due to a greater degree of perceived harm associated with ENDS, a preference for menthol, or cultural norms. However, differential adoption of ENDS by race may not continue as mentholated ENDS are increasingly marketed to African-Americans. The goal of this study is to evaluate how all smokers, including African-American and menthol smokers, experience and initiate ENDS use. Specific aims are: (1) to examine how the immediate environmental and psychological contexts of cigarette and ENDS use vary within subjects; (2) to examine how these contexts vary between subjects by menthol preference and race; and (3) to examine participants’ “lived experience” of the meaning, influences, and utility of cigarette and ENDS use. To meet these aims, investigators will conduct an observational study involving three weeks of ecological momentary assessment (EMA) and in-depth interview data collection, followed by 30-day follow-up telephone contact to assess cigarette and ENDS use. Subjects will include 100 daily cigarette smokers aged 18 and older, stratified into four groups by menthol use and race (non-Hispanic White and non-Hispanic Black). In Week 1, participants will collect baseline data on their usual smoking pattern. In Week 2, participants will receive a week’s supply of ENDS and instructions to use the products at least three times daily. In Week 3, investigators will replenish participants’ ENDS supply and encourage participants to use the products as they see fit. Over the three weeks, participants will use a previously-developed EMA data collection system to provide real-time data (at four random times per day) on immediate environmental context (location, smoking restrictions and presence of others), current psychological states (self-efficacy, outcome expectancies about ENDS and cigarette use, mood), and tobacco use-related items (craving, satisfaction, cigarette or ENDS use, and duration/amount of product used). Participants will also take part in a semi-structured in-depth interview at the end of each week; Week 1 interviews will focus on a process evaluation of the EMA data collection experience, while Week 2 and 3 interviews will focus on how ENDS-associated cognitions, expectancies and norms evolve with ENDS use and increasing familiarity with the product. Findings will provide information about the immediate environmental contexts and psychological correlates associated with ENDS initiation in menthol and non-menthol smokers interested in trying ENDS.

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