The relationship between chronic lung disease diagnosis and the susceptibility to e-cigarette use in adults: The mediation effects of psychosocial, cognitive influences, and the moderation effect of physiological factors

Mohammed M Alqahtani Jr; Abdullah M M Alanazi; Hassan Aljohani; Taha T Ismaeil; Saleh S Algarni; Tareq F Alotaibi; Mansour M Alotaibi; Mohammad Ebrahimi Kalan; Donald H Lein; Mobarak K Alqahtani; Khalid S Alwadeai; Anwar B Almutairi; Peter S Hendricks

doi:10.18332/tid/169741

The relationship between chronic lung disease diagnosis and the susceptibility to e-cigarette use in adults: The mediation effects of psychosocial, cognitive influences, and the moderation effect of physiological factors

Tob Induc Dis. 2023 Sep 22:21:116. doi: 10.18332/tid/169741. eCollection 2023.

Authors

Mohammed M Alqahtani Jr^{1

2

3}, Abdullah M M Alanazi^{1

2

3}, Hassan Aljohani^{1

2

3}, Taha T Ismaeil^{1

2

3}, Saleh S Algarni^{1

2

3}, Tareq F Alotaibi^{1

2

3}, Mansour M Alotaibi⁴, Mohammad Ebrahimi Kalan⁵, Donald H Lein⁶, Mobarak K Alqahtani^{1

2

3}, Khalid S Alwadeai⁷, Anwar B Almutairi⁸, Peter S Hendricks⁹

Affiliations

¹ Department of Respiratory Therapy, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
² King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.
³ Department of Respiratory Care, King Abdulaziz Medical City, Riyadh, Saudi Arabia.
⁴ Department of Physical Therapy, College of Applied Medical Sciences, Northern Border University, Arar, Saudi Arabia.
⁵ School of Health Professions, Eastern Virginia Medical School, Norfolk, United States.
⁶ Department of Physical Therapy, School of Health Professions, University of Alabama at Birmingham, Birmingham, United States.
⁷ Department of Rehabilitation Science, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia.
⁸ Physical Therapy Department, School of Allied Health, Kuwait University, Kuwait City, Kuwait.
⁹ Department of Psychiatry, School of Medicine, University of Alabama at Birmingham, Birmingham, United States.

Abstract

Introduction: There is a paucity of studies on e-cigarette use among adults with chronic lung disease. In the present study, we aimed to assess whether psychosocial or cognitive factors elucidate the relationship between chronic lung disease (CLD) and susceptibility to e-cigarette use and whether the relationship between CLD and e-cigarette use is conditional on the presence of respiratory symptoms.

Methods: We recruited adults aged ≥18 years in Alabama with CLD from university medical clinics (n=140) and individuals without CLD (n=123 as a reference group). Information on sociodemographics, susceptibility to e-cigarette use, psychosocial factors, and cognitive factors were collected. Mediation analysis was used to assess whether the psychosocial factors or cognitive factors explained the association between CLD and susceptibility to using e-cigarettes, and moderation analysis was conducted to determine if respiratory factors would change the association between CLD and susceptibility to e-cigarette use.

Results: Psychosocial factors (stress, depression, anxiety) and e-cigarette positive expectancy were notably high among individuals with CLD. Having CLD was associated with a lower likelihood of susceptibility to e-cigarette use. Higher levels of stress, being a smoker, boredom, taste/sensorimotor manipulation, and social facilitation were associated with higher odds of susceptibility to using e-cigarettes among individuals with CLD. Mediation analysis indicated a statistically significant indirect effect of CLD on the susceptibility to using e-cigarettes through stress and boredom reduction. We did not find a statistically significant interaction between CLD and respiratory symptoms affecting susceptibility to using e-cigarettes.

Conclusions: Individuals with CLD often exhibit stress, depression, and a positive view of e-cigarettes but are generally less inclined to use them. Stress, smoking habits, boredom, taste, and social influence can increase their susceptibility to e-cigarette use. Our findings call for further exploration to evaluate the temporal relationship between CLD status, psychosocial factors, cognitive factors, and susceptibility to using e-cigarettes.

Trial registration: The study was registered on ClinicalTrials.gov, on 5 November 2019. Identifier: NCT04151784.

Keywords: chronic lung disease; cognitive factors; psychosocial factors; susceptibility to using e-cigarettes.

Associated data

ClinicalTrials.gov/NCT04151784