Examining Electronic Nicotine Delivery System (ENDS) Cue Reactivity Using a Remote Platform: Cigarette and ENDS Desire in Dual Users

Introduction Prior research shows that in-person exposure to electronic nicotine delivery systems (ENDS) use increases the desire for cigarettes and ENDS. However, less is known about the impact of cues delivered during remote interactions. This study extends previous in-person cue work by leveraging a remote confederate-delivered cue-delivery paradigm to evaluate the impact of dual nicotine vaping (vs. sole smoking) on reactivity to an ENDS cue in individuals who smoke cigarettes.Methods N = 52 dual users (DU; current users of both combustible cigarettes and ENDS) and N = 54 sole smokers (SS; users of combustible cigarettes only) observed a study confederate drinking bottled water (control cue) and then vaping an ENDS (active cue). Changes in desire for cigarettes and ENDS were compared between groups post-cue exposure.Results Multilevel models, controlling for sex and cigarettes per day, revealed that the remote ENDS cue, but not water, significantly increased the desire for both cigarettes and ENDS. Relative to SS, DU reported greater post-ENDS cue increases in ENDS desire but not cigarette desire.Conclusions A remote, confederate-delivered ENDS cue generalizes as a smoking and vaping cue, with DU showing greater reactivity than SS. This study provides the first evidence for the validity and feasibility of a remote, confederate-delivered ENDS cue reactivity paradigm.Implications This study provides support for the use of a remote platform, an increasingly popular method of conducting research since the onset of the COVID-19 pandemic, to employ confederate-delivered ENDS cues. Frequent observations of vaping via remote platforms and social media may contribute to the maintenance of single- and dual-product use.