An Evaluation of the Contextual Factors Associated With the Use of Either Tobacco or Electronic Cigarettes in Individuals Who Dual Use

Abstract Introduction Little is known about patterns of dual use of tobacco and electronic cigarettes (e-cigarettes), especially regarding the factors that lead people to choose either product in particular situations. Identifying contextual factors that are associated with product use would enhance understanding of the maintenance of dual product use. Methods Individuals who dual use (N = 102) completed ecological momentary assessment surveys via text message regarding the recent use of tobacco and e-cigarettes for 2 weeks. Product legality, availability, craving, the presence of other people who smoke/vape, and social disapproval were assessed. Data were analyzed using hierarchical logistic regression to identify factors associated with the likelihood of tobacco versus e-cigarette use. Results Contexts associated with increased likelihood of using tobacco rather than e-cigarettes included being in the presence of other people who smoke (odds ratio [OR] = 3.50, p