"Smoker" and "Vaper" identity in people who use both cigarettes and E-cigarettes: Changes over time and associations with smoking behaviors

Background: Individuals who use both cigarettes and e-cigarettes may have multiple nicotine product use self-identities, each of which may be associated with patterns of use, including cessation. Objectives: This study examined changes in "smoker" and "vaper" identities and product use behaviors over one year among adults who used both cigarettes and e-cigarettes. We hypothesized that stronger baseline vaping identities would be associated with higher odds of smoking cessation, and stronger baseline smoking identities would be associated with continued cigarette use. Methods: Participants (N = 364), who were recruited for an observational study of cigarette and e-cigarette use, completed measures of "smoker" and "vaper" identity, nicotine dependence, and product use at baseline and 12 months. We examined associations between smoking and vaping identities and tobacco product use. Logistic regression evaluated the effects of age, gender, and baseline smoking and vaping identities on continued smoking or abstinence at 12 months. Results: Smoking and vaping identities were independent at baseline (p = .51) but associated at 12 months (p = .0001). At 12 months, "ex-smokers" had higher e-cigarette use than "smokers" and "social/occasional smokers" (p <.0001). Those who identified as "vapers" at baseline had lower odds of smoking at 12 months (OR = 2.27, "non-/ex-vaper" vs "vaper"; OR = 2.05, "social/occasional vaper" vs "vaper"). Conclusions: Smoking and vaping identities are associated with changes in tobacco product use over time.