A Comparison of Vaping Behavior, Perceptions, and Dependence among Individuals Who Vape Nicotine, Cannabis, or Both
Abstract
:1. Introduction
2. Materials and Methods
2.1. Procedures
2.2. Participants
2.3. Measures
2.3.1. Sociodemographic Characteristics
2.3.2. Cigarette and Vape Use History and Characteristics
2.3.3. Smoking Status
2.3.4. Reasons for Vape Use and Perceived Benefits and Harms
2.3.5. Cannabis Use
2.3.6. Nicotine Vape Dependence
2.3.7. Cannabis Vape Dependence
2.3.8. Cannabis Vape Use Disorder
2.3.9. Cannabis Dependence
2.3.10. Validity Check Items
2.4. Data Cleaning
2.5. Data Analysis
3. Results
3.1. Sample Characteristics
3.2. Vape Use Characteristics
3.3. Reasons for Vape Use and Perceived Benefits and Harms
3.4. Comparisons of Cannabis and Nicotine Vape Dependence by User Type
3.5. Psychometric Assessment of Cannabis Vape Measures
4. Discussion
Limitations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- Hasin, D.S.; Sarvet, A.L.; Cerdá, M.; Keyes, K.M.; Stohl, M.; Galea, S.; Wall, M.M. US Adult Illicit Cannabis Use, Cannabis Use Disorder, and Medical Marijuana Laws: 1991–1992 to 2012–2013. JAMA Psychiatry 2017, 74, 579–588. [Google Scholar] [CrossRef] [Green Version]
- Cerdá, M.; Mauro, C.; Hamilton, A.; Levy, N.S.; Santaella-Tenorio, J.; Hasin, D.; Wall, M.M.; Keyes, K.M.; Martins, S.S. Association Between Recreational Marijuana Legalization in the United States and Changes in Marijuana Use and Cannabis Use Disorder From 2008 to 2016. JAMA Psychiatry 2020, 77, 165–171. [Google Scholar] [CrossRef] [PubMed]
- SAMHSA. Key Substance Use and Mental Health Indicators in the United States: Results from the 2020 National Survey on Drug Use and Health; HHS Publication No. PEP21-07-01-003, NSDUH Series H-56; Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration: Rockville, MD, USA, 2021.
- Agrawal, A.; Budney, A.J.; Lynskey, M.T. The co-occurring use and misuse of cannabis and tobacco: A review. Addiction 2012, 107, 1221–1233. [Google Scholar] [CrossRef] [PubMed]
- Smith, D.M.; Hyland, A.; Kozlowski, L.; O’Connor, R.J.; Collins, R.L. Use of Inhaled Nicotine and Cannabis Products among Adults Who Vape Both Substances. Subst. Use Misuse 2022, 57, 432–441. [Google Scholar] [CrossRef] [PubMed]
- Agrawal, A.; Lynskey, M.T.; Pergadia, M.L.; Bucholz, K.K.; Heath, A.C.; Martin, N.G.; Madden, P.A. Early cannabis use and DSM-IV nicotine dependence: A twin study. Addiction 2008, 103, 1896–1904. [Google Scholar] [CrossRef] [Green Version]
- Meier, E.; Hatsukami, D.K. A review of the additive health risk of cannabis and tobacco co-use. Drug Alcohol Depend. 2016, 166, 6–12. [Google Scholar] [CrossRef]
- Wang, J.B.; Ramo, D.E.; Lisha, N.E.; Cataldo, J.K. Medical marijuana legalization and cigarette and marijuana co-use in adolescents and adults. Drug Alcohol Depend. 2016, 166, 32–38. [Google Scholar] [CrossRef] [Green Version]
- Peters, E.N.; Budney, A.J.; Carroll, K.M. Clinical correlates of co-occurring cannabis and tobacco use: A systematic review. Addiction 2012, 107, 1404–1417. [Google Scholar] [CrossRef] [Green Version]
- Hammond, D.; Wadsworth, E.; Reid, J.L.; Burkhalter, R. Prevalence and modes of cannabis use among youth in Canada, England, and the US, 2017 to 2019. Drug Alcohol Depend. 2021, 219, 108505. [Google Scholar] [CrossRef]
- Cornelius, M.E.; Wang, T.W.; Jamal, A.; Loretan, C.G.; Neff, L.J. Tobacco Product Use Among Adults—United States, 2019. MMWR Morb. Mortal. Wkly. Rep. 2020, 69, 1736–1742. [Google Scholar] [CrossRef]
- Breland, A.; Soule, E.; Lopez, A.; Ramoa, C.; El-Hellani, A.; Eissenberg, T. Electronic cigarettes: What are they and what do they do? Ann. N. Y. Acad. Sci. 2017, 1394, 5–30. [Google Scholar] [CrossRef] [PubMed]
- Guo, W.; Vrdoljak, G.; Liao, V.C.; Moezzi, B. Major Constituents of Cannabis Vape Oil Liquid, Vapor and Aerosol in California Vape Oil Cartridge Samples. Front. Chem. 2021, 9, 694905. [Google Scholar] [CrossRef]
- Johnston, L.; Miech, R.; O’Malley, P.; Bachman, J.; Schulenberg, J.; Patrick, M. Monitoring the Future National Survey Results on Drug Use, 1975–2021: Overview, Key Findings on Adolescent Drug Use; Institute for Social Research, University of Michigan: Ann Arbor, MI, USA, 2021. [Google Scholar]
- Boakye, E.; Obisesan, O.H.; Uddin, S.M.I.; El-Shahawy, O.; Dzaye, O.; Osei, A.D.; Benjamin, E.J.; Stokes, A.C.; Robertson, R.M.; Bhatnagar, A.; et al. Cannabis vaping among adults in the United States: Prevalence, trends, and association with high-risk behaviors and adverse respiratory conditions. Prev. Med. 2021, 153, 106800. [Google Scholar] [CrossRef]
- Kritikos, A.F.; Johnson, J.K.; Hodgkin, D. Past 30-Day Marijuana Vaping: Prevalence and Predictors of Use in a Nationally Representative Study of U.S. Youth. Am. J. Prev. Med. 2021, 60, 258–266. [Google Scholar] [CrossRef]
- Bentivegna, K.; Atuegwu, N.C.; Oncken, C.; DiFranza, J.R.; Mortensen, E.M. Electronic Cigarettes Associated with Incident and Polysubstance Use Among Youth. J. Adolesc. Health 2021, 68, 123–129. [Google Scholar] [CrossRef] [PubMed]
- Farsalinos, K.; Barbouni, A.; Niaura, R. Changes from 2017 to 2018 in e-cigarette use and in ever marijuana use with e-cigarettes among US adolescents: Analysis of the National Youth Tobacco Survey. Addiction 2021, 116, 139–149. [Google Scholar] [CrossRef] [PubMed]
- Smith, D.M.; Kozlowski, L.; O’Connor, R.J.; Hyland, A.; Collins, R.L. Reasons for individual and concurrent use of vaped nicotine and cannabis: Their similarities, differences, and association with product use. J. Cannabis Res. 2021, 3, 39. [Google Scholar] [CrossRef]
- Budney, A.J.; Sargent, J.D.; Lee, D.C. Vaping cannabis (marijuana): Parallel concerns to e-cigs? Addiction 2015, 110, 1699–1704. [Google Scholar] [CrossRef] [Green Version]
- Hindocha, C.; Shaban, N.D.; Freeman, T.P.; Das, R.K.; Gale, G.; Schafer, G.; Falconer, C.J.; Morgan, C.J.; Curran, H.V. Associations between cigarette smoking and cannabis dependence: A longitudinal study of young cannabis users in the United Kingdom. Drug Alcohol Depend. 2015, 148, 165–171. [Google Scholar] [CrossRef] [Green Version]
- Foulds, J.; Veldheer, S.; Yingst, J.; Hrabovsky, S.; Wilson, S.J.; Nichols, T.T.; Eissenberg, T. Development of a questionnaire for assessing dependence on electronic cigarettes among a large sample of ex-smoking E-cigarette users. Nicotine Tob. Res. 2015, 17, 186–192. [Google Scholar] [CrossRef] [Green Version]
- Morean, M.E.; Krishnan-Sarin, S.; Sussman, S.; Foulds, J.; Fishbein, H.; Grana, R.; O’Malley, S.S. Psychometric Evaluation of the E-cigarette Dependence Scale. Nicotine Tob. Res. 2019, 21, 1556–1564. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Van der Pol, P.; Liebregts, N.; de Graaf, R.; Korf, D.J.; van den Brink, W.; van Laar, M. Reliability and validity of the Severity of Dependence Scale for detecting cannabis dependence in frequent cannabis users. Int. J. Methods Psychiatr. Res. 2013, 22, 138–143. [Google Scholar] [CrossRef] [PubMed]
- American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-5®); American Psychiatric Pub: Lansing, MI, USA, 2013. [Google Scholar]
- Thomas, K.A.; Clifford, S. Validity and Mechanical Turk: As assessment of exclusion methods and interactive experiments. Comput. Hum. Behav. 2017, 77, 184–197. [Google Scholar] [CrossRef]
- Leavens, E.L.S.; Stevens, E.M.; Brett, E.I.; Hébert, E.T.; Villanti, A.C.; Pearson, J.L.; Wagener, T.L. JUUL electronic cigarette use patterns, other tobacco product use, and reasons for use among ever users: Results from a convenience sample. Addict. Behav. 2019, 95, 178–183. [Google Scholar] [CrossRef]
- Strickland, J.C.; Stoops, W.W. The use of crowdsourcing in addiction science research: Amazon Mechanical Turk. Exp. Clin. Psychopharmacol. 2019, 27, 1–18. [Google Scholar] [CrossRef] [PubMed]
- Mellis, A.M.; Bickel, W.K. Mechanical Turk data collection in addiction research: Utility, concerns and best practices. Addiction 2020, 115, 1960–1968. [Google Scholar] [CrossRef]
- Shapiro, D.N.; Chandler, J.; Mueller, P.A. Using Mechanical Turk to Study ClinicalPopulations. Clin. Psychol. Sci. 2013, 1, 213–220. [Google Scholar] [CrossRef]
- Harris, P.A.; Taylor, R.; Thielke, R.; Payne, J.; Gonzalez, N.; Conde, J.G. Research electronic data capture (REDCap)—A metadata-driven methodology and workflow process for providing translational research informatics support. J. Biomed. Inform. 2009, 42, 377–381. [Google Scholar] [CrossRef] [Green Version]
- National Addiction & HIV Data Archive Program. PATH Study FAQs for Researchers. Available online: https://www.icpsr.umich.edu/web/pages/NAHDAP/path-study-faq.html (accessed on 12 August 2022).
- Hamilton, C.M.; Strader, L.C.; Pratt, J.G.; Maiese, D.; Hendershot, T.; Kwok, R.K.; Hammond, J.A.; Huggins, W.; Jackman, D.; Pan, H.; et al. The PhenX Toolkit: Get the most from your measures. Am. J. Epidemiol. 2011, 174, 253–260. [Google Scholar] [CrossRef]
- Centers for Disease Control and Prevention (CDC). Behavioral Risk Factor Surveillance System Survey Questionnaire. Available online: https://www.cdc.gov/brfss/questionnaires/index.htm (accessed on 12 August 2022).
- Etter, J.F.; Bullen, C. Electronic cigarette: Users profile, utilization, satisfaction and perceived efficacy. Addiction 2011, 106, 2017–2028. [Google Scholar] [CrossRef] [Green Version]
- Farrimond, H. A typology of vaping: Identifying differing beliefs, motivations for use, identity and political interest amongst e-cigarette users. Int. J. Drug Policy 2017, 48, 81–90. [Google Scholar] [CrossRef]
- Cuttler, C.; Spradlin, A. Measuring cannabis consumption: Psychometric properties of the Daily Sessions, Frequency, Age of Onset, and Quantity of Cannabis Use Inventory (DFAQ-CU). PLoS ONE 2017, 12, e0178194. [Google Scholar] [CrossRef] [PubMed]
- Borland, R.; Yong, H.H.; O’Connor, R.J.; Hyland, A.; Thompson, M.E. The reliability and predictive validity of the Heaviness of Smoking Index and its two components: Findings from the International Tobacco Control Four Country study. Nicotine Tob. Res. 2010, 12 (Suppl. S1), S45–S50. [Google Scholar] [CrossRef] [Green Version]
- Sobieski, E.; Yingst, J.; Foulds, J. Quitting electronic cigarettes: Factors associated with quitting and quit attempts in long-term users. Addict. Behav. 2022, 127, 107220. [Google Scholar] [CrossRef]
- Yingst, J.; Wang, X.; Lopez, A.A.; Breland, A.; Soule, E.; Barnes, A.; Cohen, J.; Underwood, M.; Crabtree, M.; Foulds, J.; et al. Changes in nicotine dependence among smokers using electronic cigarettes to reduce cigarette smoking in a randomized controlled trial. Nicotine Tob. Res. 2022. [Google Scholar] [CrossRef] [PubMed]
- Meade, A.W.; Craig, S.B. Identifying careless responses in survey data. Psychol. Methods 2012, 17, 437–455. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Rouse, S.V. A reliability analysis of Mechanical Turk data. Comput. Hum. Behav. 2015, 43, 304–307. [Google Scholar] [CrossRef]
- Aguinis, H.; Villamor, I.; Ramani, R.S. MTurk research: Review and recommendations. J. Manag. 2021, 47, 823–837. [Google Scholar] [CrossRef]
- Mayer, M.; Reyes-Guzman, C.; Grana, R.; Choi, K.; Freedman, N.D. Demographic Characteristics, Cigarette Smoking, and e-Cigarette Use Among US Adults. JAMA Netw. Open 2020, 3, e2020694. [Google Scholar] [CrossRef]
- IBM Corp. IBM SPSS Statistics for Windows, Version 28; IBM Corp.: Armonk, NY, USA, 2021. [Google Scholar]
- Lynskey, M.T.; Heath, A.C.; Bucholz, K.K.; Slutske, W.S.; Madden, P.A.; Nelson, E.C.; Statham, D.J.; Martin, N.G. Escalation of drug use in early-onset cannabis users vs co-twin controls. JAMA 2003, 289, 427–433. [Google Scholar] [CrossRef]
- Schauer, G.L.; Berg, C.J.; Kegler, M.C.; Donovan, D.M.; Windle, M. Assessing the overlap between tobacco and marijuana: Trends in patterns of co-use of tobacco and marijuana in adults from 2003–2012. Addict. Behav. 2015, 49, 26–32. [Google Scholar] [CrossRef] [PubMed]
- Piper, M.E.; Baker, T.B.; Benowitz, N.L.; Kobinsky, K.H.; Jorenby, D.E. Dual Users Compared to Smokers: Demographics, Dependence, and Biomarkers. Nicotine Tob. Res. 2019, 21, 1279–1284. [Google Scholar] [CrossRef] [PubMed]
- Warner, K.E. How to think—not feel—about tobacco harm reduction. Nicotine Tob. Res. 2019, 21, 1299–1309. [Google Scholar] [CrossRef] [PubMed]
- Erku, D.; Gartner, C.E.; Morphett, K.; Snoswell, C.L.; Steadman, K.J. Nicotine vaping products as a harm reduction tool among smokers: Review of evidence and implications for pharmacy practice. Res. Soc. Adm. Pharm. 2020, 16, 1272–1278. [Google Scholar] [CrossRef]
- Notley, C.; Ward, E.; Dawkins, L.; Holland, R. The unique contribution of e-cigarettes for tobacco harm reduction in supporting smoking relapse prevention. Harm Reduct. J. 2018, 15, 31. [Google Scholar] [CrossRef]
- U.S. Department of Health and Human Services. The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General; US Department of Health and Human Services: Atlanta, GA, USA, 2014.
- Voos, N.; Goniewicz, M.L.; Eissenberg, T. What is the nicotine delivery profile of electronic cigarettes? Expert Opin. Drug Deliv. 2019, 16, 1193–1203. [Google Scholar] [CrossRef]
- Piper, M.E.; Baker, T.B.; Benowitz, N.L.; Smith, S.S.; Jorenby, D.E. E-cigarette Dependence Measures in Dual Users: Reliability and Relations With Dependence Criteria and E-cigarette Cessation. Nicotine Tob. Res. 2020, 22, 756–763. [Google Scholar] [CrossRef]
- Noack, R.; Höfler, M.; Lueken, U. Cannabis use patterns and their association with DSM-IV cannabis dependence and gender. Eur. Addict. Res. 2011, 17, 321–328. [Google Scholar] [CrossRef] [Green Version]
- Strickland, J.C.; Stoops, W.W. Feasibility, acceptability, and validity of crowdsourcing for collecting longitudinal alcohol use data. J. Exp. Anal. Behav. 2018, 110, 136–153. [Google Scholar] [CrossRef]
- Kim, H.S.; Hodgins, D.C. Reliability and validity of data obtained from alcohol, cannabis, and gambling populations on Amazon’s Mechanical Turk. Psychol. Addict. Behav. 2017, 31, 85–94. [Google Scholar] [CrossRef]
- Simpson, S.S.; Adams, N.; Brugman, C.M.; Conners, T.J. Detecting Novel and Emerging Drug Terms Using Natural Language Processing: A Social Media Corpus Study. JMIR Public Health Surveill. 2018, 4, e2. [Google Scholar] [CrossRef] [PubMed]
Nicotine-Only (n = 106) | Dual Nicotine and Cannabis (n = 357) | Cannabis-Only (n = 40) | Total (N = 503) | p-Value | |
---|---|---|---|---|---|
Sociodemographic Characteristics | |||||
Age, M (SD) (n = 503) | 37.26 (9.49) | 32.83 (7.91) | 37.25 (9.01) | 34.11 (8.57) | F (2, 502) = 14.61, p < 0.001 |
Gender Identity, n (%) (n = 501) | χ2(6) = 5.98, p = 0.425 | ||||
Male | 65 (61.3) | 225 (63.2) | 21 (53.8) | 311 (62.1) | |
Female | 40 (37.7) | 129 (36.2) | 18 (46.2) | 187 (37.3) | |
Transmale | 1 (0.9) | 0 (0) | 0 (0) | 1 (0.2) | |
Unknown | 0 (0) | 2 (0.6) | 0 (0) | 2 (0.4) | |
Race, n (%) (n = 502) | χ2(8) = 11.54, p = 0.173 | ||||
White | 93 (88.6) | 312 (87.4) | 34 (85.0) | 439 (87.5) | |
Black/African American | 7 (6.7) | 32 (9.0) | 2 (5.0) | 41 (8.2) | |
Asian | 5 (4.8) | 4 (1.1) | 2 (5.0) | 11 (2.2) | |
Other | 0 (0) | 9 (2.5) | 2 (5.0) | 11 (2.2) | |
Hispanic/Latino, n (%) (n = 503) | 7 (6.6) | 46 (12.9) | 2 (5.0) | 55 (10.9) | χ2(2) = 4.88, p = 0.087 |
Married or Living with Partner, n (%) (n = 503) | 66 (62.3) | 280 (78.4) | 26 (65.0) | 372 (74.0) | χ2(2) =12.90, p = 0.002 |
Sexual Orientation, n (%) (n = 499) | χ2(10) = 10.40, p = 0.406 | ||||
Heterosexual | 91 (85.8) | 287 (81.1) | 34 (87.2) | 412 (82.6) | |
Homosexual (Gay) | 2 (1.9) | 5 (1.4) | 1 (2.6) | 8 (1.6) | |
Homosexual (Lesbian) | 3 (2.8) | 2 (0.6) | 1 (2.6) | 6 (1.2) | |
Bisexual | 9 (8.5) | 56 (15.8) | 3 (7.7) | 68 (13.6) | |
Other or undisclosed | 1 (0.9) | 4 (1.2) | 0 (0) | 5 (1.0) | |
Bachelor’s degree or higher, n (%) (n = 501) | 57 (53.8) | 275 (77.5) | 24 (60.0) | 356 (71.1) | χ2(2) = 24.86, p < 0.001 |
Current full-time employment, n (%) (n = 503) | 91 (85.8) | 322 (90.2) | 28 (70.0) | 441 (87.7) | χ2(2) = 13.99, p < 0.001 |
Household income, Med (IQR) (n = 493) | 54,999 (44,000) | 54,999 (39,000) | 64,999 (51,000) | 54,999 (44,000) | χ2(2) = 1.89, p = 0.390 |
Cigarette smoking status, n (%) (n = 499) | χ2(4) = 95.32, p < 0.001 | ||||
Current | 64 (61.0) | 297 (83.7) | 12 (30.8) | 373 (74.7) | |
Former | 35 (33.3) | 29 (8.2) | 11 (28.2) | 75 (15.0) | |
Never | 6 (5.7) | 29 (8.2) | 16 (41.0) | 51 (10.2) | |
Nicotine Vape Use Characteristics | |||||
Age of regular use, M (SD) (n = 456) | 33.01 (10.23) | 26.19 (7.68) | 27.78 (8.82) | t(142.68) = 6.34, p < 0.001 | |
Years of use, M (SD) (n = 456) | 4.25 (3.44) | 6.66 (4.49) | 6.10 (4.39 | t(223.79) = 5.85, p < 0.001 | |
Days of use in past 30 days, M (SD) (n = 437) | 20.73 (10.49) | 16.06 (9.82) | 17.16 (10.16) | t(435) = 4.15, p < 0.001 | |
Times per day, Med (IQR) (n = 460) | 5 (12) | 6 (12) | 6 (12) | χ2(1) = 0.16, p = 0.740 | |
Nicotine concentration, M (SD) (n = 422) | 14.39 (23.36) | 24.81 (73.21) | 22.24 (64.72) | t(419.86) = 2.22, p = 0.027 | |
Stealth vaping, n (%) (n = 260) | χ2(4) = 27.85, p < 0.001 | ||||
Never | 21 (36.8) | 24 (11.8) | 45 (17.3) | ||
Rarely | 21 (36.8) | 57 (28.1) | 78 (30.0) | ||
A few times a month | 10 (17.5) | 67 (33.0) | 77 (29.6) | ||
A few times a week | 5 (8.8) | 44 (21.7) | 49 (18.8) | ||
Daily | 0 (0.0) | 11 (5.4) | 11 (4.2) | ||
Place of purchase (n = 456) | χ2(5) = 26.16, p < 0.001 | ||||
Gas station | 15 (14.2) | 26 (7.4) | 41 (9.0) | ||
Tobacco store or vape shop | 50 (47.2) | 161 (46.0) | 211 (46.3) | ||
Online store | 34 (32.1) | 116 (33.1) | 150 (32.9) | ||
Online marketplace | 3 (2.8) | 31 (8.9) | 34 (7.5) | ||
Friends/family | 0 (0.0) | 16 (4.6) | 16 (3.5) | ||
Use of vape to replace combustible, n (%) (n = 457) | 80 (76.2) | 232 (65.9) | 312 (68.3) | χ2(1) = 3.95, p = 0.047 | |
Lifetime quit attempt, n (%) (n = 460) | 18 (17.0) | 124 (35.0) | 142 (30.9) | χ2(1) = 12.45, p < 0.001 | |
Cannabis Vape Use Characteristics | |||||
Age of regular use, M (SD) (n = 380) | 27.08 (7.91) | 33.90 (9.91) | 27.80 (8.39) | t(45.03) = 4.20, p < 0.001 | |
Years of use, M (SD), (n = 380) | 5.87 (4.83) | 3.35 (3.33) | 5.61 (4.75) | t(60.19) = 4.28, p < 0.001 | |
Days of use in past 30 days, M (SD) (n = 385) | 7.61 (8.55) | 13.20 (9.46) | 8.19 (8.80) | t(383) = 3.87, p < 0.001 | |
Times per day, Med (IQR) (n = 382) | 4 (9.5) | 1 (1.0) | 3 (9) | χ2(1) = 17.93, p < 0.001 | |
THC percentage, M (SD) (n = 385) | 55.62 (24.11) | 56.28 (28.50) | 55.69 (24.55) | t(44.35) = 0.14, p = 0.890 | |
Stealth vaping, n (%) (n = 391) | χ2(4) = 7.31, p = 0.120 | ||||
Never | 85 (24.2) | 16 (40.0) | 101 (25.8) | ||
Rarely | 126 (35.9) | 13 (32.5) | 139 (35.5) | ||
A few times a month | 91 (25.9) | 10 (25.0) | 101 (25.8) | ||
A few times a week | 43 (12.3) | 1 (2.5) | 44 (11.3) | ||
Daily | 6 (1.7) | 0 (0.0) | 6 (1.5) | ||
Place of purchase, n (%) (n = 387) | χ2(7) = 74.20, p < 0.001 | ||||
Gas station | 8 (2.3) | 0 (0.0) | 8 (2.1) | ||
Tobacco store or vape shop | 102 (29.4) | 1 (2.5) | 103 (26.6) | ||
Online store | 69 (19.9) | 3 (7.5) | 72 (18.6) | ||
Online marketplace | 39 (11.2) | 1 (2.5) | 40 (10.3) | ||
Friends/family | 54 (15.6) | 4 (10.0) | 58 (15.0) | ||
Individual Seller | 36 (10.4) | 8 (20.0) | 44 (11.4) | ||
Dispensary | 35 (10.1) | 23 (57.5) | 58 (15.0) | ||
Other | 4 (1.2) | 0 (0) | 4 (1.0) | ||
Use of vape to replace combustible, n (%) (n = 386) | 155 (44.8) | 19 (47.5) | 174 (45.1) | χ2(1) = 0.106, p = 0.745 | |
Lifetime quit attempt, n (%) (n = 389) | 93 (26.6) | 5 (12.8) | 98 (25.2) | χ2(1) = 3.52, p = 0.061 | |
Combustible (leaf) cannabis use, n (%) (n = 503) | 33 (31.1) | 135 (37.8) | 21 (52.5) | 189 (37.6) | χ2(2) = 5.68, p = 0.058 |
State medical marijuana card holder, n (%) (n = 430) | 3 (8.1) | 137 (38.7) | 7 (17.9) | 147 (34.2) | χ2(2) = 18.96, p < 0.001 |
Dependence Measures | |||||
PSECDI Total Score (n = 462) | 8.03 (3.46) | 9.13 (4.44) | 8.87 (4.26) | F(1, 460) = 5.49, p = 0.020 | |
PSECDI Dependence Level (n = 462) | χ2(3) = 5.33, p = 0.149 | ||||
Not dependent | 9 (8.5) | 32 (9.0) | 41 (8.9) | ||
Low dependence | 48 (45.3) | 138 (38.8) | 186 (40.3) | ||
Medium dependence | 36 (34.0) | 107 (30.1) | 143 (31.0) | ||
High dependence | 13 (12.3) | 79 (22.2) | 92 (19.9) | ||
PSCVDI Total Score (n = 390) | 7.27 (4.98) | 5.85 (2.88) | 7.13 (4.8) | F (1, 388) = 3.13, p = 0.078 | |
PSCVDI Dependence Level (n = 390) | χ2(3) = 11.75, p = 0.008 | ||||
Not dependent | 80 (22.9) | 6 (15.0) | 86 (22.1) | ||
Low dependence | 139 (39.7) | 27 (67.5) | 166 (42.6) | ||
Medium dependence | 78 (22.3) | 5 (12.5) | 83 (21.3) | ||
High dependence | 53 (15.1) | 2 (5.0) | 55 (14.1) | ||
Cannabis Dependence Severity (SDS) (n = 392) | 4.26 (3.28) | 1.43 (2.24) | 3.97 (3.30) | F (1390) = 28.36, p < 0.001 | |
Cannabis Vape Dependence (DSM) (n = 388) | 4.07 (3.66) | 1.63 (1.46) | 3.82 (3.58) | F(1386) = 17.55, p < 0.001 |
Nicotine-Only (n = 106) | Dual Nicotine and Cannabis (n = 357) | Total (n = 463) | p-Value | |
---|---|---|---|---|
n (%) | n (%) | n (%) | ||
Nicotine Vape Reasons for Use | ||||
Ease of use | 57 (53.8) | 180 (50.4) | 237 (51.2) | χ2(1) = 0.37, p = 0.544 |
Quitting a combustible product | 52 (49.1) | 65 (18.2) | 117 (25.3) | χ2(1) = 41.19, p < 0.001 |
Health benefits | 26 (24.5) | 93 (26.1) | 119 (25.7) | χ2(1) = 0.10, p = 0.753 |
Taste | 42 (39.6) | 140 (39.2) | 182 (39.3) | χ2(1) = 0.01, p = 0.940 |
Feeling (high or alertness) | 6 (5.7) | 94 (26.3) | 100 (21.6) | χ2(1) = 20.62, p < 0.001 |
Satisfaction | 39 (36.8) | 148 (41.5) | 187 (40.4) | χ2(1) = 0.74, p = 0.390 |
Less obvious than smoking a combustible | 26 (24.5) | 68 (19.0) | 94 (20.3) | χ2(1) = 1.52, p = 0.218 |
New and interesting | 10 (9.4) | 91 (25.5) | 101 (21.8) | χ2(1) = 12.35, p < 0.001 |
Cheaper than other products | 29 (27.4) | 55 (15.4) | 84 (18.1) | χ2(1) = 7.86, p = 0.005 |
Dependence or addiction | 28 (26.4) | 41 (11.5) | 69 (14.9) | χ2(1) = 14.37, p < 0.001 |
To lose weight | 2 (1.9) | 8 (2.2) | 10 (2.2) | χ2(1) = 0.05, p = 0.826 |
Perceived Benefits of Nicotine Vape Use | ||||
Helps me cut down on the number of cigarettes I smoke | 56 (52.8) | 150 (42.0) | 206 (44.5) | χ2(1) = 3.87, p = 0.049 |
Helped me quit smoking | 43 (40.6) | 111 (31.1) | 154 (33.3) | χ2 (1)= 3.31, p = 0.069 |
Good to use in places where cigarette smoking is not allowed | 39 (36.8) | 107 (30.0) | 146 (31.5) | χ2(1) = 1.76, p = 0.184 |
Makes it so I do not have to go outside to smoke | 42 (39.6) | 94 (26.3) | 136 (29.4) | χ2(1) = 6.96, p = 0.008 |
Less harmful to my health than smoking cigarettes | 56 (52.8) | 119 (33.3) | 175 (37.8) | χ2(1) = 13.22, p < 0.001 |
Reduces harmful effects on my family or friends | 35 (33.0) | 82 (23.0) | 117 (25.3) | χ2(1) = 4.37, p = 0.037 |
Cheaper than smoking cigarettes | 45 (42.5) | 81 (22.7) | 126 (27.2) | χ2(1) = 16.12, p < 0.001 |
Reduces the risk of lung cancer | 27 (25.5) | 81 (22.7) | 108 (23.3) | χ2(1) = 0.35, p = 0.552 |
Reduces the risk of mouth or throat cancer | 19 (17.9) | 69 (19.3) | 88 (19.0) | χ2(1) = 0.11, p = 0.746 |
Reduces my coughing with mucous | 27 (25.5) | 52 (14.6) | 79 (17.1) | χ2(1) = 6.87, p = 0.009 |
Makes me less short of breath and improves my breathing | 24 (22.6) | 47 (13.2) | 71 (15.3) | χ2(1) = 5.65, p = 0.017 |
Makes my hands and clothes smell less bad | 53 (50.0) | 66 (18.5) | 119 (25.7) | χ2(1) = 42.50, p < 0.001 |
Reduces my bad breath and bad odors | 39 (36.8) | 58 (16.2) | 97 (21.0) | χ2(1) = 20.83, p < 0.001 |
Improves my sense of smell and ability to taste | 20 (18.9) | 44 (12.3) | 64 (13.8) | χ2(1) = 2.94, p = 0.087 |
Tastes good | 57 (53.8) | 119 (33.3) | 176 (38.0) | χ2(1) = 14.49, p < 0.001 |
Feels good when inhaling | 36 (34.0) | 110 (30.8) | 146 (31.5) | χ2(1) = 0.38, p = 0.540 |
Reduces my urges or craving to smoke | 50 (47.2) | 57 (16.0) | 107 (23.1) | χ2(1) = 44.78, p < 0.001 |
Makes it easier to keep from smoking cigarettes | 52 (49.1) | 58 (16.2) | 110 (23.8) | χ2(1) = 48.57, p < 0.001 |
Keeps me from bothering other people with my smoke | 35 (33.0) | 50 (14.0) | 85 (18.4) | χ2(1) = 19.71, p < 0.001 |
Takes away my craving to smoke faster than cigarette smoking does | 11 (10.4) | 30 (8.4) | 41 (8.9) | χ2(1) = 0.40, p = 0.530 |
Gives me as much or more nicotine than I can get by smoking cigarettes | 18 (17.0) | 27 (7.6) | 45 (9.7) | χ2(1) = 8.26, p = 0.004 |
Reduces nicotine withdrawal | 28 (26.4) | 49 (13.7) | 77 (16.6) | χ2(1) = 9.49, p = 0.002 |
Helps me sleep better | 9 (8.5) | 42 (11.8) | 51 (11.0) | χ2(1) = 0.89, p = 0.344 |
Produces large clouds and shapes from vapor | 8 (7.5) | 36 (10.1) | 44 (9.5) | χ2(1) = 0.61, p = 0.434 |
Trendy | 11 (10.4) | 65 (18.2) | 76 (16.4) | χ2(1) = 3.65, p = 0.056 |
More socially acceptable than smoking | 33 (31.3) | 52 (14.6) | 85 (18.4) | χ2(1) = 14.97, p < 0.001 |
Allows me to experiment with flavors | 19 (17.9) | 44 (12.3) | 63 (13.6) | χ2(1) = 2.18, p = 0.140 |
Gets me high | 1 (0.9) | 27 (7.6) | 28 (6.0) | χ2(1) = 6.30, p = 0.012 |
Makes me more alert | 10 (9.4) | 31 (8.7) | 41 (8.9) | χ2(1) = 0.057, p = 0.811 |
Healthier than combustible cigarettes | 34 (32.1) | 38 (10.6) | 72 (15.6) | χ2(1) = 28.59, p < 0.001 |
Perceived Harms of Nicotine Vape Use | ||||
The vapor that they make contains other chemicals which are not safe; they can hurt my health | 45 (42.5) | 84 (23.5) | 129 (27.9) | χ2(1) = 14.56, p < 0.001 |
I am still getting nicotine so I would stay addicted | 53 (50.0) | 110 (30.8) | 163 (35.2) | χ2(1) = 13.19, p < 0.001 |
The nicotine vapor from electronic cigarettes causes lung cancer | 12 (11.3) | 64 (17.9) | 76 (16.4) | χ2(1) = 2.60, p = 0.107 |
The nicotine vapor from electronic cigarettes causes wet cough with mucous (brown liquid) | 9 (8.5) | 68 (19.0) | 77 (16.6) | χ2(1) = 6.57, p = 0.010 |
The nicotine vapor from electronic cigarettes causes a dry cough | 10 (9.4) | 68 (19.0) | 78 (16.8) | χ2(1) = 5.39, p = 0.020 |
The nicotine vapor from electronic cigarettes causes lung problems | 22 (20.8) | 77 (21.6) | 99 (21.4) | χ2(1) = 0.03, p = 0.858 |
The nicotine vapor from electronic cigarettes causes mouth or throat cancer | 10 (9.4) | 58 (16.2) | 68 (14.7) | χ2(1) = 3.03, p = 0.082 |
The nicotine vapor from electronic cigarettes makes me short of breath | 4 (3.8) | 43 (12.0) | 47 (10.2) | χ2(1) = 6.13, p = 0.013 |
Using them burns my throat. | 12 (11.3) | 65 (18.2) | 77 (16.6) | χ2(1) = 2.80, p = 0.095 |
Using them gives me a dry mouth or dry throat | 18 (17.0) | 67 (18.8) | 85 (18.4) | χ2(1) = 0.17, p = 0.677 |
Electronic cigarettes have toxic substances in them | 25 (23.6) | 71 (19.9) | 96 (20.7) | χ2(1) = 0.68, p = 0.410 |
Electronic cigarettes do not stop me from having urges or cravings to smoke | 16 (15.1) | 41 (11.5) | 57 (12.3) | χ2(1) = 0.99, p = 0.321 |
I do not get enough nicotine from electronic cigarettes | 7 (6.6) | 40 (11.2) | 47 (10.2) | χ2(1) = 1.90, p = 0.168 |
It is too difficult to adjust how much nicotine I get with electronic cigarettes | 7 (6.6) | 36 (10.1) | 43 (9.3) | χ2(1) = 1.18, p = 0.278 |
Electronic cigarettes are addicting | 36 (34.0) | 79 (22.1) | 115 (24.8) | χ2(1) = 6.13, p = 0.013 |
Electronic cigarettes do not help me quit smoking | 17 (16.0) | 52 (14.6) | 69 (14.9) | χ2(1) = 0.14, p = 0.709 |
If I use electronic cigarettes to quit smoking cigarettes, I will just go back to smoking when I stop using them | 25 (23.6) | 51 (14.3) | 76 (16.4) | χ2(1) = 5.15, p = 0.023 |
Using electronic cigarettes gives me headaches or nausea or makes me feel dizzy | 4 (3.8) | 34 (9.5) | 38 (8.2) | χ2(1) = 3.59, p = 0.058 |
Electronic cigarettes taste bad | 2 (1.9) | 14 (3.9) | 16 (3.5) | χ2(1) = 1.01, p = 0.314 |
Electronic cigarettes cause me to gain weight | 2 (1.9) | 12 (3.4) | 14 (3.0) | χ2(1) = 0.61, p = 0.436 |
Dual Nicotine and Cannabis (n = 357) | Cannabis-Only (n = 40) | Total (n = 397) | p-Value | |
---|---|---|---|---|
n (%) | n (%) | n (%) | ||
Cannabis Vape Reasons for Use | ||||
Ease of use | 126 (35.3) | 26 (65.0) | 152 (38.3) | χ2(1) = 13.43, p < 0.001 |
Quitting a combustible product | 38 (10.6) | 3 (7.5) | 41 (10.3) | χ2(1) = 0.38, p = 0.535 |
Health benefits | 82 (23.0) | 6 (15.0) | 88 (22.2) | χ2(1) = 1.32, p = 0.250 |
Taste | 117 (32.8) | 8 (20.0) | 125 (31.5) | χ2(1) = 2.72, p = 0.099 |
Feeling (high or alertness) | 91 (25.5) | 17 (42.5) | 108 (27.2) | χ2(1) = 5.26, p = 0.022 |
Satisfaction | 122 (34.2) | 10 (25.0) | 132 (33.2) | χ2(1) = 1.36, p = 0.243 |
Less obvious than smoking a combustible | 60 (16.8) | 14 (35.0) | 74 (18.6) | χ2(1) = 7.85, p = 0.005 |
New and interesting | 59 (16.5) | 6 (15.0) | 65 (16.4) | χ2(1) = 0.06, p = 0.805 |
Cheaper than other products | 21 (5.9) | 0 (0.0) | 21 (5.3) | χ2(1) = 2.48, p = 0.115 |
Dependence or addiction | 23 (6.4) | 1 (2.5) | 24 (6.0) | χ2(1) =0.98, p = 0.321 |
To lose weight | 8 (2.2) | 0 (0.0) | 8 (2.0) | χ2(1) = 0.92, p = 0.339 |
Perceived Benefits of Cannabis Vape Use | ||||
Helps me cut down on the amount of marijuana I smoke | 59 (16.5) | 7 (17.5) | 66 (16.6) | χ2(1) = 0.03, p = 0.875 |
Helped me quit smoking marijuana | 66 (18.5) | 1 (2.5) | 67 (16.9) | χ2(1) = 6.55, p = 0.010 |
Is good to use in places where smoking marijuana is not allowed | 81 (22.7) | 12 (30.0) | 93 (23.4) | χ2(1) = 1.07, p = 0.301 |
Makes it so I do not have to go outside to smoke | 89 (24.9) | 11 (27.5) | 100 (25.2) | χ2(1) = 0.13, p = 0.723 |
Is less harmful to my health than smoking marijuana | 69 (19.3) | 7 (17.5) | 76 (19.1) | χ2(1) = 0.08, p = 0.781 |
Reduces harmful effects on my family or friends | 62 (17.4) | 2 (5.0) | 64 (16.1) | χ2(1) = 4.07, p = 0.044 |
Is cheaper than smoking marijuana | 55 (15.4) | 3 (7.5) | 58 (14.6) | χ2(1) = 1.80, p = 0.179 |
Reduces the risk of lung cancer | 52 (14.6) | 5 (12.5) | 57 (14.4) | χ2(1) = 0.13, p = 0.724 |
Reduces the risk of mouth or throat cancer | 37 (10.4) | 1 (2.5) | 38 (9.6) | χ2(1) = 2.57, p = 0.109 |
Reduces my coughing with mucous | 38 (10.6) | 7 (17.5) | 45 (11.3) | χ2(1) = 1.68, p = 0.195 |
Makes me less short of breath and improves my breathing | 32 (9.0) | 5 (12.5) | 37 (9.3) | χ2(1) = 0.53, p = 0.466 |
Makes my hands and clothes smell less bad | 44 (12.3) | 14 (35.0) | 58 (14.6) | χ2(1) = 14.83, p= <0.001 |
Reduces my bad breath and bad odors | 40 (11.2) | 3 (7.5) | 43 (10.8) | χ2(1) = 0.51, p = 0.475 |
Improves my sense of smell and ability to taste | 32 (9.0) | 0 (0.0) | 32 (8.1) | χ2(1) = 3.90, p = 0.048 |
Tastes good | 82 (23.0) | 14 (35.0) | 96 (24.2) | χ2(1) = 2.84, p = 0.092 |
Feels good when inhaling | 72 (20.2) | 8 (20.0) | 80 (20.2) | χ2(1) = 0.01, p = 0.980 |
Reduces my urges or craving to smoke | 36 (10.1) | 2 (5.0) | 38 (9.6) | χ2(1) = 1.07, p = 0.300 |
Makes it easier to keep from smoking marijuana | 26 (7.3) | 2 (5.0) | 28 (7.1) | χ2(1) = 0.29, p = 0.593 |
Keeps me from bothering other people with my smoke | 38 (10.6) | 10 (25.0) | 48 (12.1) | χ2(1) = 6.97, p = 0.008 |
Takes away my craving to smoke faster than marijuana smoking does | 22 (6.2) | 2 (5.0) | 24 (6.0) | χ2(1) = 0.09, p = 0.770 |
Gives me a bigger high than I can get by smoking marijuana | 36 (10.1) | 8 (20.0) | 44 (11.1) | χ2(1) = 3.59, p = 0.058 |
Reduces withdrawal | 23 (6.4) | 0 (0.0) | 23 (5.8) | χ2(1) = 2.74, p = 0.098 |
Helps me sleep better | 58 (16.2) | 17 (42.5) | 75 (18.9) | χ2(1) = 16.18, p <0.001 |
Perceived Harms of Nicotine Vape Use | ||||
The vapor they make contains other chemicals that are not safe; they hurt my health | 43 (12.0) | 9 (22.5) | 52 (13.1) | χ2(1) = 3.45, p = 0.063 |
I still get THC so I stay addicted | 59 (16.5) | 4 (10.0) | 63 (15.9) | χ2(1) = 1.15, p = 0.284 |
The vapor from electronic cigarettes causes lung cancer | 49 (13.7) | 6 (15.0) | 55 (13.9) | χ2(1) = 0.05, p = 0.825 |
The vapor from electronic cigarettes causes wet cough with mucous | 48 (13.4) | 4 (10.0) | 52 (13.1) | χ2(1) = 0.38, p = 0.540 |
The vapor from electronic cigarettes causes dry cough | 70 (19.6) | 9 (22.5) | 79 (19.9) | χ2(1) = 0.19, p = 0.664 |
The vapor from electronic cigarettes causes lung problems | 56 (15.7) | 6 (15.0) | 62 (15.6) | χ2(1) = 0.01, p = 0.910 |
The vapor from electronic cigarettes causes mouth or throat cancer | 59 (16.5) | 2 (5.0) | 61 (15.4) | χ2(1) = 3.68, p = 0.055 |
The vapor from electronic cigarettes makes me short of breath | 43 (12.0) | 2 (5.0) | 45 (11.3) | χ2(1) = 1.78, p = 0.183 |
Using them burns my throat | 64 (17.9) | 10 (25.0) | 74 (18.6) | χ2(1) = 1.19, p = 0.276 |
Using them gives me a dry mouth or dry throat | 53 (14.8) | 9 (22.5) | 62 (15.6) | χ2(1) = 1.60, p = 0.206 |
Electronic cigarettes have toxic substances in them | 51 (14.3) | 5 (12.5) | 56 (14.1) | χ2(1) = 0.10, p = 0.758 |
Electronic cigarettes don’t stop me from having urges or cravings to smoke | 47 (13.2) | 2 (5.0) | 49 (12.3) | χ2(1) = 2.22, p = 0.137 |
I do not get enough THC/cannabis from electronic cigarettes | 28 (7.8) | 7 (17.5) | 35 (8.8) | χ2(1) = 4.17, p = 0.041 |
It is too difficult to adjust how much THC/cannabis I get with electronic cigarettes | 41 (11.5) | 5 (12.5) | 46 (11.6) | χ2(1) = 0.04, p = 0.849 |
Electronic cigarettes are addicting | 51 (14.3) | 2 (5.0) | 53 (13.4) | χ2(1) = 2.68, p = 0.102 |
Electronic cigarettes do not help me quit smoking | 45 (12.6) | 6 (15.0) | 51 (12.8) | χ2(1) = 0.18, p = 0.668 |
If I use electronic cigarettes to quit smoking, I will just go back to smoking when I stop using them | 29 (8.1) | 1 (2.5) | 30 (7.6) | χ2(1) = 1.63, p = 0.202 |
Using electronic cigarettes gives me headaches or nausea or makes me feel dizzy | 24 (6.7) | 1 (2.5) | 25 (6.3) | χ2(1) = 1.09, p = 0.297 |
Electronic cigarettes taste bad | 16 (4.5) | 8 (20.0) | 24 (6.0) | χ2(1) = 15.25, p < 0.001 |
Electronic cigarettes cause me to gain weight | 14 (3.9) | 1 (2.5) | 15 (3.8) | χ2(1) = 0.20, p = 0.655 |
Cannabis Vape Dependence (n = 363) | Nicotine Vape Dependence (n = 403) | |||||||||
---|---|---|---|---|---|---|---|---|---|---|
B | 95% CI | β | ΔR2 | B | 95% CI | β | ΔR2 | |||
LL | UL | LL | UL | |||||||
Step 1 | 0.07 *** | 0.03 * | ||||||||
Age | −0.07 * | −0.13 | −0.01 | −0.12 | −0.07 ** | −0.12 | −0.02 | −0.14 | ||
Bachelor’s degree vs. less | 0.93 | −0.26 | 2.13 | 0.09 | 0.79 | −0.19 | 1.77 | 0.09 | ||
Full-time employment vs. not | 0.13 | −1.38 | 1.63 | 0.01 | −0.29 | −1.65 | 1.06 | −0.02 | ||
Married vs. not | 0.81 | −0.38 | 2.00 | 0.07 | 0.28 | −0.69 | 1.25 | 0.03 | ||
Smoking status | 1.76 ** | 0.54 | 2.98 | 0.15 | 0.33 | −0.68 | 1.34 | 0.03 | ||
Step 2 | 0.16 *** | 0.09 *** | ||||||||
Years of vape use | 0.13 * | 0.03 | 0.23 | 0.13 | 0.20 *** | 0.10 | 0.30 | 0.20 | ||
Days of vape use in past 30 days | 0.08 ** | 0.03 | 0.14 | 0.15 | 0.11 *** | 0.07 | 0.15 | 0.27 | ||
Place of purchase | 0.26 | −0.29 | 0.81 | 0.05 | -- | -- | -- | -- | ||
State medical card vs. not | 3.20 *** | 2.16 | 4.23 | 0.33 | -- | -- | -- | -- | ||
Nicotine concentration | -- | -- | -- | -- | −0.01 * | −0.01 | 0.00 | −0.10 * | ||
Step 3 | 0.01 | 0.01 | ||||||||
User type (dual vs. single) | 0.11 | −1.52 | 1.73 | 0.01 | 0.87 | −0.12 | 1.87 | 0.09 |
PSCVDI (r) | DSM-V (r) | SDS (r) | |
---|---|---|---|
Criterion Validity | |||
DSM-V | 0.66 | -- | -- |
SDS | 0.49 | 0.56 | -- |
VAS—How addicted are you? | 0.51 | 0.58 | 0.72 |
Convergent Validity | |||
Years of cannabis vape use | 0.20 | 0.29 | 0.32 |
Age of regular cannabis vape use | −0.23 | −0.35 | −0.29 |
Stealth vaping | 0.43 | 0.49 | 0.59 |
THC percentage | 0.30 | 0.32 | 0.32 |
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. |
© 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Saran, S.K.; Salinas, K.Z.; Foulds, J.; Kaynak, Ö.; Hoglen, B.; Houser, K.R.; Krebs, N.M.; Yingst, J.M.; Allen, S.I.; Bordner, C.R.; et al. A Comparison of Vaping Behavior, Perceptions, and Dependence among Individuals Who Vape Nicotine, Cannabis, or Both. Int. J. Environ. Res. Public Health 2022, 19, 10392. https://doi.org/10.3390/ijerph191610392
Saran SK, Salinas KZ, Foulds J, Kaynak Ö, Hoglen B, Houser KR, Krebs NM, Yingst JM, Allen SI, Bordner CR, et al. A Comparison of Vaping Behavior, Perceptions, and Dependence among Individuals Who Vape Nicotine, Cannabis, or Both. International Journal of Environmental Research and Public Health. 2022; 19(16):10392. https://doi.org/10.3390/ijerph191610392
Chicago/Turabian StyleSaran, Savreen K., Kalin Z. Salinas, Jonathan Foulds, Övgϋ Kaynak, Brianna Hoglen, Kenneth R. Houser, Nicolle M. Krebs, Jessica M. Yingst, Sophia I. Allen, Candace R. Bordner, and et al. 2022. "A Comparison of Vaping Behavior, Perceptions, and Dependence among Individuals Who Vape Nicotine, Cannabis, or Both" International Journal of Environmental Research and Public Health 19, no. 16: 10392. https://doi.org/10.3390/ijerph191610392