title: E-cigarettes and expectancies: why do some users keep smoking?
abstract: OBJECTIVE
  Many smokers who have tried electronic cigarettes ('e-cigarettes') continue to smoke, perhaps influenced by their beliefs about the outcomes of using e-cigarettes ('e-cigarette expectancies'). The primary aims of this study were to compare expectancies of dual users to former smokers, and to examine the association between expectancies and intentions to quit or reduce 'vaping' among former smokers.
  
  
  METHODS
  A large cross-sectional online survey of e-cigarette users conducted in the United States.
  
  
  METHODS
  We surveyed current e-cigarette users (n = 1815), including both current cigarette smokers ('dual users', n = 381) and former smokers (n = 1434). We further subdivided former smokers into those with (n = 686) and without (n = 748) intentions to reduce or quit e-cigarette use.
  
  
  METHODS
  The primary outcomes were self-reported past-month smoking status and, among former smokers, current intentions to reduce or quit e-cigarette use, both adjusted for potential confounders. E-cigarette expectancy items were derived primarily from a previously validated measure of smoking expectancies.
  
  
  RESULTS
  Dual users reported less positive expectancies than former smokers about e-cigarettes, rating e-cigarettes as more physically irritating (β = 0.10, P < 0.001) and addictive (β = 0.06, P = 0.016), as well as less satisfying (β = -0.11, P < 0.001). Former smokers with intentions to quit e-cigarettes also rated e-cigarettes less positively than former smokers without intentions to quit e-cigarettes, rating them more likely to damage health (β = 0.16, P < 0.001) and cause addiction (β = 0.10, P < 0.001), but less likely to taste good (β = -0.08, P = 0.006).
  
  
  CONCLUSIONS
  Positive e-cigarette expectancies among e-cigarette users are associated with a greater likelihood of having quit smoking, but lower likelihood of intention to quit e-cigarette use.
authors.affiliation: Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA.
authors.forename: Paul T
authors.initials: PT
authors.lastname: Harrell
authors.affiliation: Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA.|Department of Psychology, University of South Florida, Tampa, FL, USA.
authors.forename: Vani N
authors.initials: VN
authors.lastname: Simmons
authors.affiliation: Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA.|Department of Clinical Psychology, Faculty of Psychology, University of Santiago de Compostela, Spain.
authors.forename: Barbara
authors.initials: B
authors.lastname: Piñeiro
authors.affiliation: Department of Psychology, University of South Florida, Tampa, FL, USA.
authors.forename: John B
authors.initials: JB
authors.lastname: Correa
authors.affiliation: Department of Psychology, University of South Florida, Tampa, FL, USA.
authors.forename: Nicole S
authors.initials: NS
authors.lastname: Menzie
authors.affiliation: Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA.
authors.forename: Lauren R
authors.initials: LR
authors.lastname: Meltzer
authors.affiliation: Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA.|Department of Psychology, University of South Florida, Tampa, FL, USA.
authors.forename: Marina
authors.initials: M
authors.lastname: Unrod
authors.affiliation: Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA.|Department of Psychology, University of South Florida, Tampa, FL, USA.
authors.forename: Thomas H
authors.initials: TH
authors.lastname: Brandon
mesh_terms: D000293:Adolescent; D000328:Adult; D001290:Attitude; D003430:Cross-Sectional Studies; D066300:Electronic Nicotine Delivery Systems / Q000523:psychology*; D005260:Female; D006801:Humans; D033182:Intention; D008297:Male; D008875:Middle Aged; D010549:Personal Satisfaction; D057566:Self Report; D012907:Smoking / Q000523:psychology*; D016540:Smoking Cessation / Q000523:psychology*; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Dual use; e-cigarettes; electronic nicotine delivery systems; expectancies; harm reduction; nicotine; tobacco; treatment; vapers; vaping