E-Cigarette Use, Dependence, and The Use of Protective Behavioral Strategies: A Path Model

<i>Background</i>: E-cigarettes have become a popular form of nicotine use. The use of protective behavioral strategies (PBS) has been associated with less use of alcohol and fewer alcohol-related consequences. However, the relationship between PBS and e-cigarette-related outcomes have been understudied. Guided by the Theory of Planned Behavior, we examined the associations between the use of PBS for vaping (PBSV), perceived behavioral control over using PBSV, the frequency of past month e-cigarette use, and e-cigarette dependence. <i>Methods</i>: Adults who reported using an e-cigarette for at least once a day were recruited and completed an online survey (<i>N</i> = 298). <i>Results</i>: The path analytic model with e-cigarette dependence as the outcome fit the data well. Greater perceived behavioral control was associated with greater use of PBSV, greater use of PBSV was associated with less e-cigarette use, and less e-cigarette use was associated with less dependence. <i>Conclusions</i>: Our findings contribute to understanding e-cigarette use harm reduction strategies in the context of confidence over using PBS, frequency of e-cigarette use, and e-cigarette dependence. Results highlight the need for continued research and exploration of the potential clinical and public health benefits of PBSV as an intervention for e-cigarette use behaviors and dependence.

<i>研究背景</i>：电子烟已成为流行的尼古丁摄入方式。保护性行为策略（Protective Behavioral Strategies, PBS）的使用与更低的酒精摄入量及更少的酒精相关不良结局相关。然而，目前针对PBS与电子烟相关结局之间关联的研究仍较为匮乏。本研究以计划行为理论（Theory of Planned Behavior）为指导，考察了电子烟使用相关保护性行为策略（PBS for vaping, PBSV）的使用情况、对PBSV实施的感知行为控制、过去一个月电子烟使用频率与电子烟依赖之间的关联。
<i>研究方法</i>：本研究招募了日均使用电子烟至少1次的成年参与者，并完成了线上问卷调研，有效样本量为298例（N=298）。
<i>研究结果</i>：以电子烟依赖为因变量的路径分析模型对数据的拟合效果良好。更高的感知行为控制与更高的PBSV使用频率显著相关；更高的PBSV使用频率与更低的电子烟使用频率相关；而更低的电子烟使用频率又与更轻的依赖程度相关。
<i>研究结论</i>：本研究结果有助于从PBS使用信心、电子烟使用频率及电子烟依赖的视角，理解电子烟使用的减害策略。研究结果同时提示，未来仍需进一步开展研究，探索将PBSV作为电子烟使用行为与依赖的干预手段所具备的潜在临床与公共卫生价值。