Erin A. Vogel

All Publications

• Nicotine delivery and cigarette equivalents from vaping a JUULpod. Tobacco control Prochaska, J. J., Vogel, E. A., Benowitz, N. 2021

  Abstract

  With patented nicotine salt technology, JUUL dominates the e-cigarette market. We reviewed studies of JUUL's nicotine pharmacokinetic profile and studies quantifying nicotine in a JUULpod, emitted in the aerosol and absorbed by users. Examined in eight studies, JUUL's peak nicotine levels were half to three-quarters that of a combustible cigarette in industry-conducted studies with JUUL-naive users, while comparable to or greater than combustible cigarettes in independent studies of experienced e-cigarette users. JUUL Labs reports each 5% (nicotine-by-weight) cartridge contains approximately 40mg nicotine per pod and is 'approximately equivalent to about 1 pack of cigarettes.' In five independent studies, nicotine in the liquid in a JUULpod ranged from 39.3 to 48.3 mg. Seven studies measured nicotine delivery via vaping-machine generated aerosols, varying in puffing regimes and equipment. One study estimated 68% transfer efficiency to the aerosol, measuring 28.8mg nicotine per JUULpod. The other studies reported nicotine values ranging from 72 to 164g/puff. At 200 puffs, this is 14.4-32.8mg of nicotine per pod with equivalence to 13-30 cigarettes. A study measuring nicotine levels in JUUL users during a 5-day controlled switch found equivalence to 18 cigarettes. One JUULpod appears capable of delivering the nicotine equivalent to smoking about a pack of cigarettes, with variability. In JUUL-naive smokers, JUUL's nicotine boost was lower than that of combustible cigarettes; while in experienced users, JUUL was comparable. Minimising harshness and adaptive to user experience, JUUL's design facilitates initiation to a high nicotine, and ultimately, highly addictive vaping product.

  View details for DOI 10.1136/tobaccocontrol-2020-056367

  View details for PubMedID 33762429

• A Therapeutic Relational Agent for Reducing Problematic Substance Use (Woebot): Development and Usability Study. Journal of medical Internet research Prochaska, J. J., Vogel, E. A., Chieng, A., Kendra, M., Baiocchi, M., Pajarito, S., Robinson, A. 2021; 23 (3): e24850

  Abstract

  BACKGROUND: Misuse of substances is common, can be serious and costly to society, and often goes untreated due to barriers to accessing care. Woebot is a mental health digital solution informed by cognitive behavioral therapy and built upon an artificial intelligence-driven platform to deliver tailored content to users. In a previous 2-week randomized controlled trial, Woebot alleviated depressive symptoms.OBJECTIVE: This study aims to adapt Woebot for the treatment of substance use disorders (W-SUDs) and examine its feasibility, acceptability, and preliminary efficacy.METHODS: American adults (aged 18-65 years) who screened positive for substance misuse without major health contraindications were recruited from online sources and flyers and enrolled between March 27 and May 6, 2020. In a single-group pre/postdesign, all participants received W-SUDs for 8 weeks. W-SUDs provided mood, craving, and pain tracking and modules (psychoeducational lessons and psychotherapeutic tools) using elements of dialectical behavior therapy and motivational interviewing. Paired samples t tests and McNemar nonparametric tests were used to examine within-subject changes from pre- to posttreatment on measures of substance use, confidence, cravings, mood, and pain.RESULTS: The sample (N=101) had a mean age of 36.8 years (SD 10.0), and 75.2% (76/101) of the participants were female, 78.2% (79/101) were non-Hispanic White, and 72.3% (73/101) were employed. Participants' W-SUDs use averaged 15.7 (SD 14.2) days, 12.1 (SD 8.3) modules, and 600.7 (SD 556.5) sent messages. About 94% (562/598) of all completed psychoeducational lessons were rated positively. From treatment start to end, in-app craving ratings were reduced by half (87/101, 86.1% reporting cravings in the app; odds ratio 0.48, 95% CI 0.32-0.73). Posttreatment assessment completion was 50.5% (51/101), with better retention among those who initially screened higher on substance misuse. From pre- to posttreatment, confidence to resist urges to use substances significantly increased (mean score change +16.9, SD 21.4; P<.001), whereas past month substance use occasions (mean change -9.3, SD 14.1; P<.001) and scores on the Alcohol Use Disorders Identification Test-Concise (mean change -1.3, SD 2.6; P<.001), 10-item Drug Abuse Screening Test (mean change -1.2, SD 2.0; P<.001), Patient Health Questionnaire-8 item (mean change 2.1, SD 5.2; P=.005), Generalized Anxiety Disorder-7 (mean change -2.3, SD 4.7; P=.001), and cravings scale (68.6% vs 47.1% moderate to extreme; P=.01) significantly decreased. Most participants would recommend W-SUDs to a friend (39/51, 76%) and reported receiving the service they desired (41/51, 80%). Fewer felt W-SUDs met most or all of their needs (22/51, 43%).CONCLUSIONS: W-SUDs was feasible to deliver, engaging, and acceptable and was associated with significant improvements in substance use, confidence, cravings, depression, and anxiety. Study attrition was high. Future research will evaluate W-SUDs in a randomized controlled trial with a more diverse sample and with the use of greater study retention strategies.TRIAL REGISTRATION: ClinicalTrials.gov NCT04096001; http://clinicaltrials.gov/ct2/show/NCT04096001.

  View details for DOI 10.2196/24850

  View details for PubMedID 33755028

• Physical activity and stress management during COVID-19: a longitudinal survey study. Psychology & health Vogel, E. A., Zhang, J. S., Peng, K., Heaney, C. A., Lu, Y., Lounsbury, D., Hsing, A. W., Prochaska, J. J. 2021: 1–11

  Abstract

  OBJECTIVE: Physical activity (PA) during COVID-19 shelter-in-place (SIP) may offset stress. This study examined associations between PA, stress and stress management strategies during SIP.DESIGN AND MAIN OUTCOME MEASURES: Participants (N=990) from a cohort of Northern California adults completed surveys during early SIP (3/23/20-4/2/20) and mid-SIP (4/24/20-5/8/20). Participants self-reported past-month PA (meeting vs. not meeting guidelines), changes in stress (decreased/unchanged vs. increased) and use (yes/no) of 10 stress management strategies. We tested differences in mid-SIP stress and stress management strategies by PA, and differences in mid-SIP stress by stress management strategies.RESULTS: Compared to participants inactive at mid-SIP, active participants reported less stress (AOR = 0.60 [0.45, 0.81]). Active participants were more likely to manage stress using outdoor PA, indoor PA, yoga/meditation/prayer, gardening, and reading (AORs > 1.42), and less likely to sleep (AOR = 0.65 [0.48, 0.89]) or eat ([AOR = 0.48 [0.35, 0.66]) more. Managing stress using outdoor PA, indoor PA or reading was associated with lower stress; managing stress using TV/movies, sleeping or eating was associated with increased stress (ps < 0.05).CONCLUSIONS: Meeting PA guidelines during SIP was associated with less stress. Inactive participants reported greater sleeping and eating to cope; active participants used active stress management strategies. Engagement in physically active stress management was associated with lower stress.

  View details for DOI 10.1080/08870446.2020.1869740

  View details for PubMedID 33405969

• Tobacco product use and susceptibility to use among sexual minority and heterosexual adolescents. Preventive medicine Garcia, L. C., Vogel, E. A., Prochaska, J. J. 2020: 106384

  Abstract

  Sexual identity is associated with tobacco use in adults. We examined tobacco use and susceptibility to use by sexual identity in adolescents. Data were collected in February 2019 via Qualtrics research participant panels. Data analyses were performed in June 2019 and updated in October 2020. Respondents aged 13-17 reported sexual identity (heterosexual vs. sexual minority [lesbian, gay, bisexual, or other]), past-month and lifetime tobacco product use, susceptibility to e-cigarette use, friend(s)' e-cigarette use, tobacco marketing exposure, and demographic characteristics. The sample (n=983) was 72.9% female, 46.5% non-Hispanic white, and 26.1% sexual minority with mean age of 15.0 years (SD=1.4). Sexual minority adolescents were more likely to have friend(s) who vape (53.0% versus 42.0%; p=0.003). In adjusted models, sexual minority adolescents had greater odds of ever smoking tobacco (odds ratio [OR]=2.06; 95% confidence interval [CI]: 1.42-2.98) or using e-cigarettes (OR=1.55; 95% CI: 1.08-2.25) relative to heterosexual adolescents. Past-month tobacco smoking and e-cigarette use did not differ by sexual identity. Among participants who had never used tobacco products, sexual minority adolescents reported greater susceptibility to e-cigarette use (OR=1.62; 95% CI: 1.04-2.52) compared to heterosexual adolescents. Exposure to cigarette and e-cigarette marketing, e-cigarette use by friends, and respondent sex were significant covariates in all models. The current findings indicate greater susceptibility to use e-cigarettes and greater tobacco product initiation, but not continuation, among sexual minority adolescents. Sexual minority-tailored interventions may be warranted to prevent tobacco product initiation. Worth exploring are the associations between sexual identity, tobacco marketing exposure, and friend(s)' e-cigarette use.

  View details for DOI 10.1016/j.ypmed.2020.106384

  View details for PubMedID 33359018

• Vaping-Related Mobile Apps Available in the Google Play Store After the Apple Ban: Content Review. Journal of medical Internet research Meacham, M. C., Vogel, E. A., Thrul, J. 2020; 22 (11): e20009

  Abstract

  BACKGROUND: In response to health concerns about vaping devices (eg, youth nicotine use, lung injury), Apple removed 181 previously approved vaping-related apps from the App Store in November 2019. This policy change may lessen youth exposure to content that glamorizes vaping; however, it may also block important sources of information and vaping device control for adults seeking to use vaping devices safely.OBJECTIVE: Understanding the types of nicotine and cannabis vaping-related apps still available in the competing Google Play Store can shed light on how digital apps may reflect information available to consumers.METHODS: In December 2019, we searched the Google Play Store for vaping-related apps using the keywords "vape" and "vaping" and reviewed the first 100 apps presented in the results. We reviewed app titles, descriptions, screenshots, and metadata to categorize the intended substance (nicotine or cannabis/tetrahydrocannabinol) and the app's purpose. The most installed apps in each purpose category were downloaded and evaluated for quality and usability with the Mobile App Rating Scale.RESULTS: Of the first 100 apps, 79 were related to vaping. Of these 79 apps, 43 (54%) were specific to nicotine, 3 (4%) were specific to cannabis, 1 (1%) was intended for either, and for the remaining 31 (39%), the intended substance was unclear. The most common purposes of the apps were making do-it-yourself e-liquids (28/79, 35%) or coils (25/79, 32%), games/entertainment (19/79, 24%), social networking (16/79, 20%), and shopping for vaping products (15/79, 19%). Of the 79 apps, at least 4 apps (5%) paired with vaping devices to control temperature or dose settings, 8 apps (10%) claimed to help people quit smoking using vaping, and 2 apps (3%) had the goal of helping people quit vaping.CONCLUSIONS: The majority of vaping-related apps in the Google Play Store had features either to help users continue vaping, such as information for modifying devices, or to maintain interest in vaping. Few apps were for controlling device settings or assisting with quitting smoking or vaping. Assuming that these Google Play Store apps were similar in content to the Apple App Store apps that were removed, it appears that Apple's ban would have a minimal effect on people who vape with the intention of quitting smoking or who are seeking information about safer vaping via mobile apps.

  View details for DOI 10.2196/20009

  View details for PubMedID 33185565

• Sponsorship Disclosures and Perceptions of E-cigarette Instagram Posts TOBACCO REGULATORY SCIENCE Vogel, E. A., Guillory, J., Ling, P. M. 2020; 6 (5): 355–68

  View details for DOI 10.18001/TRS.6.5.5

  View details for Web of Science ID 000564230800005

• Occupying multiple stigmatized identities: Smoking and unemployment stigmas among the unemployed. SSM - population health Fielding-Singh, P., Vogel, E. A., Prochaska, J. J. 2020; 11: 100598

  Abstract

  Stigma - which involves stereotyping, discrimination, and status loss - is a central driver of morbidity and mortality. Given the de-normalization of smoking and the status loss of unemployment, unemployed individuals who smoke may occupy multiple stigmatized identities. As such, this study examined aspects and correlates of smoking and unemployment stigmas among unemployed job-seekers who smoke. Adult job-seekers who smoke tobacco (N=360) were recruited at government-run employment development departments (EDDs) in the San Francisco Bay Area in 2015-2018. Participants completed measures of smoking and unemployment stigma and self-reported their demographic, tobacco use, and physical and mental health characteristics. Smoking and unemployment stigmas were moderately positively correlated, and the sample reported higher unemployment stigma than smoking stigma. A sample majority endorsed at least one element of smoking and unemployment stigmas; most common for both was self-disappointment. Two sets of linear regression analyses using a general-to-specific modeling procedure were run to identify significant correlates of smoking stigma and unemployment stigma. Both stigmas were significantly associated with depressive symptoms and with preparing to quit smoking. Participants in poorer health and those with stable housing endorsed greater smoking stigma, while unemployment stigma was endorsed more among White individuals and those with past-year e-cigarette use. The findings highlight the need to examine multiply occupied stigmas as a social determinant of population health.

  View details for DOI 10.1016/j.ssmph.2020.100598

  View details for PubMedID 32490137

• Popularity of natural American Spirit cigarettes is greater in U.S. cities with lower smoking prevalence. Addictive behaviors Vogel, E. A., Henriksen, L., Johnson, T. O., Schleicher, N. C., Prochaska, J. J. 2020; 111: 106558

  Abstract

  BACKGROUND: Often perceived as a safer smoke, Natural American Spirit (NAS) may find particular appeal in communities with strong non-smoking norms. We hypothesized NAS would be more popular in cities with lower smoking prevalence, with the pattern unique to NAS. We tested household income, cigarette taxes, and young adult population as alternative correlates and examined brand specificity, relative to Marlboro and Pall Mall.METHODS: Using proprietary, city-specific sales estimates obtained from Nielsen for 30 U.S. cities over one year (9/7/18-9/9/19), we computed cigarette sales volume as standard pack units per 10,000 adult smokers for NAS and Marlboro and Pall Mall. Linear regression models examined associations between city-level sales volume and adult smoking prevalence, median household income, the sum of state/local cigarette excise taxes, and young adult population.RESULTS: NAS sales volume averaged 44,785 packs per 10,000 adult smokers (SD=47,676). Across 30 cities, adult smoking prevalence averaged 18.0% (SD=4.5%), median household income averaged $53,677 (SD=$14,825), cigarette excise tax averaged $2.55 (SD=$1.63), and young adult population averaged 10.6% (SD=2.2%). NAS sales volume was greater in cities with lower adult smoking prevalence (beta=-0.39, 95% CI[-0.74, -0.03], p=0.034), a pattern that was not observed for Marlboro or Pall Mall (ps>0.356). Marlboro (beta=-0.40, 95% CI[-0.76, -0.05], p=0.027) and Pall Mall (beta=-0.48, 95% CI[-0.82, -0.14], p=0.008) sales volumes were higher in cities where cigarette excise taxes were lower, a pattern not observed for NAS (p=0.224).CONCLUSION: NAS appears to be more popular in cities with lower smoking prevalence and may deter efforts to further decrease prevalence.

  View details for DOI 10.1016/j.addbeh.2020.106558

  View details for PubMedID 32745944

• Measuring e-cigarette addiction among adolescents TOBACCO CONTROL Vogel, E. A., Prochaska, J. J., Rubinstein, M. L. 2020; 29 (3): 258–62

  View details for DOI 10.1136/tobaccocontrol-2018-054900

  View details for Web of Science ID 000531878400005

• We're in this together: Promoting health equity, diversity, and inclusion in tobacco research for sexual and gender minority populations. Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco Dermody, S. S., Heffner, J. L., Hinds, J. T., McQuoid, J., Quisenberry, A. J., Tan, A. S., Vogel, E. A. 2020

  Abstract

  Sexual and gender minority (SGM) individuals have higher tobacco use prevalence and consequently higher burden of tobacco-caused diseases including cancer and cardiovascular disease compared with their heterosexual or cisgender counterparts. Yet, there is a critical gap in research focused on measuring SGM tobacco-related health disparities and addressing unmet needs of SGM individuals in the context of nicotine and tobacco research. In this commentary, we summarize recommendations discussed during a preconference workshop focused on challenges and opportunities in conducting SGM tobacco control research at the 2019 Society for Research on Nicotine and Tobacco Annual Meeting. Specifically, we recommend defining and measuring SGM identity in all nicotine and tobacco research routinely, using novel methods to engage a demographically diverse sample of the SGM population, and eliciting SGM community voices in tobacco control research. Addressing these critical research gaps will enable the scientific community to generate the data to fully understand and support SGM individuals in tobacco use prevention and cessation.

  View details for DOI 10.1093/ntr/ntaa070

  View details for PubMedID 32335682

• Effects of Social Media on Adolescents' Willingness and Intention to Use E-Cigarettes: An Experimental Investigation. Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco Vogel, E. A., Ramo, D. E., Rubinstein, M. L., Delucchi, K. L., Darrow, S. n., Costello, C. n., Prochaska, J. J. 2020

  Abstract

  This study examined effects of experimentally manipulated social media exposure on adolescents' willingness and intention to use e-cigarettes.Participants were 135 adolescents age 13-18 (52.6% female, M age=15.3) in California. Participants viewed 6 social media posts online in a 2 (post source: peer or advertisement) X 2 (e-cigarette content exposure: heavy or light) between-subjects design. Analyses were weighted to population benchmarks. We examined adolescents' beliefs, willingness, and intention to use e-cigarettes in association with social media use intensity in daily life and with experimentally manipulated exposure to social media posts that varied by source (peer or advertisement) and content (e-cigarette heavy or light).Greater social media use in daily life was associated with greater willingness and intention to use e-cigarettes and more positive attitudes, greater perceived norms, and lower perceived danger of e-cigarette use (all p-values<.01). In tests of the experimental exposures, heavy (versus light) e-cigarette content resulted in greater intention (p=.049) to use e-cigarettes and more positive attitudes (p=.019). Viewing advertisements (versus peer-generated posts) resulted in greater willingness and intention (p-values<.01) to use e-cigarettes, more positive attitudes (p=.003), and greater norm perceptions (p=.009). The interaction effect of post source by post content was not significant for any of the outcomes (all p-values>0.529).Greater social media use and heavier exposure to advertisements and e-cigarette content in social media posts are associated with a greater risk for e-cigarette use among adolescents. Regulatory action is needed to prohibit sponsored e-cigarette content on social media platforms used by youth.

  View details for DOI 10.1093/ntr/ntaa003

  View details for PubMedID 31912147

• Sponsorship Disclosures and Perceptions of E-cigarette Instagram Posts. Tobacco regulatory science Vogel, E. A., Guillory, J. n., Ling, P. M. 2020; 6 (5): 355–68

  Abstract

  Instagram influencers have many followers and are often paid to promote products, including e-cigarettes. This experimental study assessed effects of sponsorship disclosures on perceptions of e-cigarette Instagram influencer posts.Young adult e-cigarette users (age 18-29; N = 917) were randomly assigned to 3 experimental conditions varying the clarity of sponsorship disclosure on simulated Instagram influencer posts: clear (eg, "#sponsored") ambiguous (eg, "#sp"), or no disclosure (ie, vaping-related hashtags only). After viewing each of 4 Instagram posts featuring a fictitious e-cigarette brand, participants reported hashtag recognition, ad recognition, ad trust, influencer credibility, and post engagement intentions. After viewing all posts, participants reported brand attitudes, brand use intentions, and vaping intentions.With greater recognition of clear (but not ambiguous) disclosure hashtags, ad recognition increased (p = .001), perceptions of influencer credibility decreased (p = .022), and intentions to engage with posts decreased (p = .008). Ad trust was lower with greater hashtag recognition regardless of disclosures (p < .001). Sponsorship disclosures did not significantly affect brand attitudes, brand use intentions, or vaping intentions.Recognizing clear sponsorship disclosures may influence young adults' perceptions of and engagement with e-cigarette Instagram posts but may not affect perceptions or use of products.

  View details for DOI 10.18001/trs.6.5.5

  View details for PubMedID 33778107

  View details for PubMedCentralID PMC7996397

• Strategies to improve treatment utilization for substance use disorders: A systematic review of intervention studies. Drug and alcohol dependence Vogel, E. A., Ly, K. n., Ramo, D. E., Satterfield, J. n. 2020; 212: 108065

  Abstract

  Many people who need specialty treatment for substance use disorders (SUDs) do not receive it. Clinical interventions could increase treatment utilization but are not routinely used. This systematic review aimed to describe clinical interventions that may increase SUD specialty treatment utilization (i.e., treatment initiation, attendance, meaningful engagement) and to determine which intervention(s) most consistently increase treatment utilization.We conducted a systematic review of clinical intervention studies (published in English between 2000 and 2017) reporting outcomes relevant to specialty SUD treatment utilization. Outcomes were treatment initiation, attendance, and meaningful engagement. Risk of bias was assessed using Cochrane guidelines and randomized controlled trials (RCTs) with bias scores < 3 were included in a synthesis of results. Proportions of positive to negative utilization outcomes were calculated for each low-bias RCT; studies with 50% positive outcomes or more were considered "majority-positive". Studies were categorized by theory-based approach.Twenty-three RCTs had low risk of bias and were synthesized. Among intervention types with two or more studies, cognitive-behavioral (100% majority-positive) and coordinated care (67% majority-positive) interventions were most likely to increase treatment initiation, while 12-step promotion interventions were most likely to increase treatment attendance (50% majority-positive). One study (12-step promotion) measured meaningful engagement, with majority-positive outcomes.A systematic review and narrative synthesis of clinical interventions promoting specialty SUD treatment utilization provided preliminary evidence that cognitive-behavioral and coordinated care interventions may increase treatment initiation, while 12-step promotion interventions may promote treatment attendance. More quality studies and greater consistency in treatment utilization measurement are needed.

  View details for DOI 10.1016/j.drugalcdep.2020.108065

  View details for PubMedID 32442754

• Prevalence of Electronic Cigarette Dependence Among Youth and Its Association With Future Use. JAMA network open Vogel, E. A., Cho, J. n., McConnell, R. S., Barrington-Trimis, J. L., Leventhal, A. M. 2020; 3 (2): e1921513

  Abstract

  Understanding the prevalence and symptoms of electronic cigarette (e-cigarette) dependence and its association with future e-cigarette use among youth may help to guide pediatric clinical services and health policy.To examine the cross-sectional prevalence and symptom presentation of e-cigarette dependence and to determine whether e-cigarette dependence is associated with subsequent e-cigarette use patterns 6 months later among youth with baseline past-year e-cigarette use.This prospective cohort study used baseline and 6-month follow-up surveys among students in the 12th grade during the 2016 to 2017 school year who reported any past-year e-cigarette use. Surveys were conducted on site in 10 high schools in Los Angeles, California. Data were analyzed from March 2019 to December 2019.Self-reported checklist of 10 tobacco product dependence symptoms reflecting loss of control over use, craving or urge, or withdrawal symptoms while abstinent, completed at baseline and administered separately for e-cigarettes and combustible cigarettes. Reporting 1 or more symptoms indicated a positive screen for dependence. Vaping continuation, defined as any past 6-month vaping, and past 30-day nicotine vaping days (range, 0-30), sessions per vaping day (range, 0-20), and puffs per session (range, 0-20) at 6-month follow-up were assessed.Among 3168 twelfth-grade students who completed the baseline survey, 444 youths (mean [SD] age, 17.48 [0.39] years; 217 [48.9%] female) reported past-year e-cigarette use. Among these, 52 youths (11.7%) reported at least 1 e-cigarette dependence symptom. Among youth who reported past-year dual e-cigarette and combustible cigarette use, combustible cigarette dependence, reported by 43 youths (29.7%), was more prevalent than e-cigarette dependence, which was reported by 24 youths (16.4%). The most common symptoms, craving, urge, and need to use, and least common symptoms, abstinence-related concentration and emotional problems, were similar in both combustible and e-cigarette dependence. The prevalence of e-cigarette dependence was higher among youth who reported vaping in the past month than among those who did not (41 youths [17.6%] vs 11 youths [5.2%]; P < .001) and among youth who used e-cigarettes with nicotine than among those who used e-cigarettes without nicotine (42 youths [15.2%] vs 10 youths [6.0%]; P = .004). After adjusting for baseline vaping and e-cigarette dependence risk propensity scores, baseline e-cigarette dependence symptom status was associated with vaping continuation (adjusted odds ratio, 2.30 [95% CI, 1.07-4.94]; P = .02) and past 30-day number of nicotine vaping days (adjusted rate ratio, 2.17 [95% CI, 1.44-3.28]; P < .001), vaping sessions per day (adjusted rate ratio, 2.41 [95% CI, 1.52-3.83]; P < .001), and puffs per session (adjusted rate ratio, 1.70 [95% CI, 1.09-2.66]; P = .02) at 6-month follow-up.These findings suggest that e-cigarette dependence may be an expression of tobacco use disorder associated with future use persistence and escalation among youth. Electronic cigarette dependence may be a behavioral health consequence of adolescent vaping that warrants consideration in pediatric patient care and public health policy.

  View details for DOI 10.1001/jamanetworkopen.2019.21513

  View details for PubMedID 32074292

• Sexual and gender minority young adults' smoking characteristics: Assessing differences by sexual orientation and gender identity ADDICTIVE BEHAVIORS Vogel, E. A., Humfleet, G. L., Meacham, M., Prochaska, J. J., Ramo, D. E. 2019; 95: 98–102

  View details for DOI 10.1016/j.addbeh.2019.03.005

  View details for Web of Science ID 000472703300016

• Adolescents' E-Cigarette Use: Increases in Frequency, Dependence, and Nicotine Exposure Over 12Months. The Journal of adolescent health : official publication of the Society for Adolescent Medicine Vogel, E. A., Prochaska, J. J., Ramo, D. E., Andres, J., Rubinstein, M. L. 2019; 64 (6): 770–75

  Abstract

  PURPOSE: This study examined changes in e-cigarette and dual-use frequency, levels of nicotine exposure and e-cigarette dependence, and device and e-liquid preferences over 12months.METHODS: Adolescents (N= 173, aged 13-18 years) who reported past-month e-cigarette use and at least 10 lifetime uses were recruited from the San Francisco Bay Area. The sample was 75.1% male, 54.9% non-Hispanic White, mean age 16.6years (standard deviation= 1.2); 26.6% reported past-month cigarette smoking at baseline (i.e., dual use). At baseline, 6-month, and 12-month follow-up, participants provided saliva samples for cotinine testing and self-reported e-cigarette use frequency, dependence, past-month smoking, product preference, and flavor preference.RESULTS: Most (80.3%) were still using e-cigarettes at 12 months, and daily use increased from 14.5% to 29.8%. Model testing indicated an overall increase from baseline to 12months in frequency of e-cigarette use (F(2, 166)= 5.69, p= .004), dependence (F(2, 164)= 5.49, p= .005), and cotinine levels (F(2, 103)= 4.40, p= .038). Among those reporting only e-cigarette use at baseline, 28.8% reported combustible cigarette use during follow-up. Among those reporting dual use at baseline, 57.1% were still dual using at 12 months, 31.4% reported e-cigarette use only, and none abstained from both products. Higher nicotine delivering e-cigarette devices (i.e., Juul, mods) became more popular over time, whereas flavor preferences (i.e., fruit, mint/menthol, and candy) remained stable.CONCLUSIONS: Adolescents' e-cigarette use persisted over a 12-month period with significant increases in frequency of use, nicotine exposure, and e-cigarette dependence. Transitions from single to dual and dual to single nicotine product use were observed in approximately one in three users over the study period.

  View details for DOI 10.1016/j.jadohealth.2019.02.019

  View details for PubMedID 31122507

• Development and acceptability testing of a Facebook smoking cessation intervention for sexual and gender minority young adults. Internet interventions Vogel, E. A., Belohlavek, A. n., Prochaska, J. J., Ramo, D. E. 2019; 15: 87–92

  Abstract

  This study tested engagement in and acceptability of a digital smoking cessation intervention designed for young adults and tailored to sexual and gender minority (SGM) individuals. The intervention included 90 Facebook posts delivered in private groups tailored to readiness to quit smoking (Ready to quit in 30 days/Not Ready; 180 posts total; 101 posts SGM-tailored by content/image). Acceptability was evaluated over 30 days (3 posts/day). Participants' (N = 27) open-ended feedback was coded and tallied; posts with significant negative feedback were flagged for change. Flags and comment volume were examined by SGM tailoring (versus not tailored) and content category (motivational interviewing, experiential strategies, behavioral strategies, relevant topics). Engagement and acceptability were high. All participants reported viewing at least half of the posts, and the majority reported viewing all 90 posts (M comments per participant = 51.74). The majority of participants agreed or strongly agreed with statements about the intervention's helpfulness and clarity. Posts received an average of 8.08 comments (SD = 2.58), with 59 posts (32.8%) flagged for change. Posts engaged comments and were found to be acceptable at comparable levels regardless of SGM tailoring and content category (all p-values > .189). SGM young adult smokers were highly engaged in an SGM-tailored smoking cessation intervention on Facebook and rated the intervention positively. Both tailored and non-tailored Facebook posts in a variety of content areas were generally well-received by SGM young adults, an underserved population with high rates of smoking.

  View details for PubMedID 30792958

• The Put It Out Project (POP) Facebook Intervention for Young Sexual and Gender Minority Smokers: Outcomes of a Pilot Randomized Controlled Trial. Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco Vogel, E. A., Ramo, D. E., Meacham, M. C., Prochaska, J. J., Delucchi, K. L., Humfleet, G. L. 2019

  Abstract

  This trial investigated whether a Facebook smoking cessation intervention culturally tailored to young sexual and gender minority (SGM) smokers (versus non-tailored) would increase smoking abstinence.Participants were 165 SGM young adult U.S. smokers (age 18-25) recruited from Facebook in April 2018 and randomized to an SGM-tailored (POP; N=84) or non-tailored (TSP-SGM; N=81) intervention. Interventions delivered weekly live counseling sessions and 90 daily Facebook posts to participants in Facebook groups. Primary analyses compared POP and TSP-SGM on biochemically verified smoking abstinence (yes/no; primary outcome), self-reported 7-day point prevalence abstinence (yes/no), reduction in cigarettes per week by 50+% from baseline (yes/no), making a quit attempt during treatment (yes/no), and stage of change (precontemplation/contemplation vs. preparation/action). Supplemental analyses compared POP to two historical control groups.POP participants were more likely than TSP-SGM participants to report smoking abstinence at 3 (23.8% vs. 12.3%; OR=2.50; p=.03) and 6 months (34.5% vs. 12.3%; OR=4.06; p<.001) and reduction in smoking at 3 months (52.4% vs. 39.5%; OR=2.11; p=.03). Biochemically verified smoking abstinence did not significantly differ between POP and TSP-SGM at 3 (OR=2.00; p=.33) or 6 months (OR=3.12; p=.08), potentially due to challenges with remote biochemical verification. In supplemental analyses, POP participants were more likely to report abstinence at 3 (OR=6.82, p=.01) and 6 (OR=2.75, p=.03) months and reduced smoking at 3 months (OR=2.72, p=.01) than participants who received a referral to Smokefree.gov.This pilot study provides preliminary support for the effectiveness of a Facebook smoking cessation intervention tailored to SGM young adults.Sexual and gender minority (SGM) individuals have disproportionately high smoking prevalence. It is unclear whether smoking cessation interventions culturally tailored to the SGM community are more effective than non-tailored interventions. This pilot trial found preliminary evidence that an SGM-tailored Facebook smoking cessation intervention increased reported abstinence from smoking, compared to a non-tailored intervention.

  View details for DOI 10.1093/ntr/ntz184

  View details for PubMedID 31562765

• Multiple Health Risk Behaviors in Young Adult Smokers: Stages of Change and Stability over Time. Annals of behavioral medicine : a publication of the Society of Behavioral Medicine Ramo, D. E., Thrul, J. n., Vogel, E. A., Delucchi, K. n., Prochaska, J. J. 2019

  Abstract

  Health risk behaviors (HRBs) are common, yet not well understood in young adult smokers.We examined HRB profiles over 12 months in young adult smokers participating in a Facebook smoking cessation intervention clinical trial.Participants (N = 500; age M = 20.9 years; 54.6% women) were recruited online and randomized to receive either a 3-month Facebook smoking cessation intervention or referral to Smokefree.gov (control). A Health Risk Assessment determined risk for 10 behaviors at baseline and 3, 6, and 12 months. Latent class analysis (LCA) and latent transition analysis (LTA) were used to identify patterns of HRBs and changes over time.At baseline, participants reported an average of 5.4 (standard deviation [SD] = 1.7) risk behaviors, including smoking (100%), high-fat diet (84.8%), poor sleep hygiene (71.6%), and low fruit and vegetable intake (69.4%). A 3-class model fit the data best at baseline and all follow-up time points: low risk (28.8% at baseline) with low likelihood of risk on all behaviors except smoking, substance use risk (14.0% at baseline) characterized by heavy episodic drinking, cannabis use, and other illicit drug use, and metabolic risk (57.2% at baseline), with a high percentage of members at risk for a low fruit and vegetable intake, high-fat diet, inactivity, stress, and poor sleep hygiene. Classes were very stable at 3, 6, and 12 months, with few participants transitioning between classes.Most young adult smokers engaged in multiple risk behaviors, with meaningful clustering of behaviors, and demonstrated stability over a year's time. In addition to smoking, targets for intervention are co-occurring substance use and metabolic risk behaviors.NCT02207036.

  View details for DOI 10.1093/abm/kaz025

  View details for PubMedID 31157881

• Smoking Cessation Intervention Trial Outcomes for Sexual and Gender Minority Young Adults HEALTH PSYCHOLOGY Vogel, E. A., Thrul, J., Humfleet, G. L., Delucchi, K. L., Ramo, D. E. 2019; 38 (1): 12–20

  Abstract

  Sexual and gender minority (SGM) individuals are more likely to smoke than are non-SGM individuals. It is unclear whether smoking cessation interventions for young adults are effective in the SGM population. The purpose of this study was to compare smoking cessation, other health risk behaviors, and intervention usability between SGM and non-SGM young adult smokers participating in a digital smoking cessation intervention trial.Young adult smokers (N = 500; 135 SGM) were assigned to a 90-day Facebook smoking cessation intervention (treatment) or referred to Smokefree.gov (control). Intervention participants were assigned to private Facebook groups tailored to their readiness to quit smoking. Participants reported their smoking status and other health risk behaviors at baseline, 3, 6, and 12 months. Usability of the intervention (i.e., perceptions of the intervention and treatment engagement) was assessed in the intervention group at 3 months.Smoking cessation and intervention usability did not significantly differ between SGM participants and non-SGM participants. A greater proportion of SGM participants were at high risk for physical inactivity over the 12-month follow-up period (odds ratio [OR] = 1.55, p = .005).SGM and non-SGM young adult smokers did not differ in their smoking cessation rates, perceptions of, or engagement in a digital intervention. Health risk behavior patterns were mostly similar; however, the disparity in physical activity between SGM and non-SGM smokers widened over time. Tailored interventions for SGM young adult smokers could increase focus on SGM experiences that can underlie multiple health risk behaviors, such as discrimination and the normativity of smoking. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  View details for DOI 10.1037/hea0000698

  View details for Web of Science ID 000453765500002

  View details for PubMedID 30489104

  View details for PubMedCentralID PMC6415665

• Comparing comparisons: Assimilation and contrast processes and outcomes following social and temporal comparison Self and Identity Vogel, E. A., Rose, J. P., Aspiras, O. G., Edmonds, K. A., Gallinari, E. F. 2019

  View details for DOI 10.1080/15298868.2019.1647278

• Associations between marijuana use and tobacco cessation outcomes in young adults JOURNAL OF SUBSTANCE ABUSE TREATMENT Vogel, E. A., Rubinstein, M. L., Prochaska, J. J., Ramo, D. E. 2018; 94: 69–73

  Abstract

  Marijuana and tobacco co-use is common among young adults, and findings are mixed regarding the association between marijuana use and smoking cessation outcomes. This study examined the longitudinal relationships between marijuana use and smoking cessation outcomes among young adults (aged 18-25 years; N = 500) enrolled in a 3-month smoking cessation intervention on Facebook. At baseline and 3, 6, and 12 months, participants reported their marijuana use and their smoking behaviors (seven-day point prevalence abstinence from smoking, cigarettes per day, quit attempts) and readiness to quit. Longitudinal analyses controlled for experimental condition and adjusted for baseline stage of change, baseline average cigarettes per day, sex, alcohol use, and age participants began smoking regularly. Use of marijuana by young adult smokers was associated with a lower likelihood of reduced smoking (OR = 0.71, 95% CI [0.51, 0.98], p = .036) and a lower likelihood of abstaining from smoking (OR = 0.56, 95% CI [0.35, 0.90], p = .017) in the past seven days, as assessed over 12 months of follow-up. Use of marijuana was not significantly associated with perceptions of or engagement in the smoking cessation intervention, stage of change for quitting smoking, or tobacco quit attempts (all p's > 0.08). Study findings indicate that while marijuana use is unrelated to motivation to quit tobacco and engage in cessation interventions, marijuana use is associated with less success in reducing and abstaining from tobacco. Additional support and targeted tobacco cessation strategies to address challenges associated with marijuana co-use may be needed.

  View details for PubMedID 30243420

• Prevalence and correlates of adolescents' e-cigarette use frequency and dependence DRUG AND ALCOHOL DEPENDENCE Vogel, E. A., Ramo, D. E., Rubinstein, M. L. 2018; 188: 109–12

  Abstract

  Understanding predictors of e-cigarette use among adolescents in the context of wide availability and extreme popularity of these products is important for prevention and treatment. This study identifies correlates of e-cigarette use frequency and dependence among adolescent users.Adolescent e-cigarette users (N = 173) were recruited from the San Francisco Bay Area. Participants reported demographic and psychosocial characteristics, e-cigarette use behaviors, and cigarette use. Bivariate relationships between potential correlates were examined, and correlates significant at p < .10 were included in full models predicting frequency and dependence.In the full models, frequent use was associated with receiving one's first e-cigarette from a family member rather than a friend (r = -0.23, p < .001) or a store ( = -0.13, p = .037), using nicotine in all e-cigarettes versus some e-cigarettes (r = -0.17, p = .007) or unknown nicotine use (r = -0.15, p = .014), using a customizable device versus a Juul (r = -0.22, p < .001), vape pen (r = -0.20, p = .002), or other/unknown device (r = -0.16, p = .009), and friends' e-cigarette use (r = 0.20, p = .002). Dependence was associated with younger age of first use (r = -0.18, p = .012), friends' use (r = 0.18, p = .01), and recent cigarette use (r = 0.17, p = .019).When assessing problematic e-cigarette use among adolescents, it is important to consider social factors (e.g., friends' and family members' e-cigarette use), device type, and dual use with cigarettes.

  View details for DOI 10.1016/j.drugalcdep.2018.03.051

  View details for Web of Science ID 000436912700016

  View details for PubMedID 29763848

  View details for PubMedCentralID PMC5999577

• "Transformation Tuesday": Temporal context and post valence influence the provision of social support on social media JOURNAL OF SOCIAL PSYCHOLOGY Vogel, E. A., Rose, J. P., Crane, C. 2018; 158 (4): 446–59

  Abstract

  Social network sites (SNSs) such as Facebook have become integral in the development and maintenance of interpersonal relationships. Users of SNSs seek social support and validation, often using posts that illustrate how they have changed over time. The purpose of the present research is to examine how the valence and temporal context of an SNS post affect the likelihood of other users providing social support. Participants viewed hypothetical SNS posts and reported their intentions to provide social support to the users. Results revealed that participants were more likely to provide social support for posts that were positive and included temporal context (i.e., depicted improvement over time; Study 1). Furthermore, this research suggests that visual representations of change over time are needed to elicit social support (Study 2). Results are discussed in terms of their practical implications for SNS users and theoretical implications for the literature on social support and social media.

  View details for DOI 10.1080/00224545.2017.1385444

  View details for Web of Science ID 000432701500004

  View details for PubMedID 29023225

• The Application of Persuasion Theory to Placebo Effects NEUROBIOLOGY OF THE PLACEBO EFFECT, PT I Geers, A. L., Brinol, P., Vogel, E. A., Aspiras, O., Caplandies, F. C., Petty, R. E., Colloca, L. 2018; 138: 113–36

  Abstract

  Placebo effects, or positive outcomes resulting from expectations about a treatment, are powerful components of modern medical care. In this chapter, we suggest that our understanding of placebo effects may benefit from more explicitly connecting this phenomenon to the existing empirical psychological literature on persuasion. Persuasion typically involves an attempt to bring about a change in beliefs or attitudes as a result of providing information on a topic. We begin by providing a brief overview of the psychological literature on placebo effects. We then point to connections between this literature and research on persuasive communication. Although some links have been made, these initial connections have predominantly relied on classic theories of persuasion rather than on more contemporary and comprehensive models. Next, we describe a modern theory of persuasion that may facilitate the study of placebo effects and analyze two issues pertinent to the literature on placebo effects from the lens of this model. Specifically, we consider how and when characteristics of a practitioner (e.g., variables such as perceptions of a practitioner's confidence or competence) can influence the magnitude of placebo effects, and how modern persuasion theory can help in understanding the durability of placebo effects over time. We conclude that examining placebo effects as an outcome of persuasive communication would be a fruitful line of future research.

  View details for DOI 10.1016/bs.irn.2018.01.004

  View details for Web of Science ID 000436628500008

  View details for PubMedID 29681321

• Experiencing is believing: prior experience moderates the impact of self-based and socially-based cues in the context of blood donation JOURNAL OF BEHAVIORAL MEDICINE Roberts, L., Rose, J. P., Vogel, E. A. 2017; 40 (6): 998–1010

  Abstract

  Two studies explored how self-based cues (i.e., self-efficacy), socially-based cues (i.e., perceived social norms), and prior blood donation experience differentially influence behavioral intentions. In Study 1, undergraduate students (N = 766) completed an online study that evaluated prior experiences, self-efficacy, perceived norms, and behavioral intentions in the context of blood donation. In Study 2, a community sample (N = 199) from a clinic waiting room completed similar measures. Across both studies, having high self-efficacy was a necessary and sufficient antecedent to high intentions, regardless of norm perception for donors. For non-donors, however, high self-efficacy was necessary but not sufficient; non-donors' intentions were higher when giving blood was perceived to be normative, but far lower when it was not. When self-efficacy was low, the effects of experience and norms did not exert meaningful effects and donation intentions were quite low. These results demonstrate that the impact of self-based and socially-based cues on behavioral intentions may differ as a function of experience. The findings can inform public health initiatives and enhance the accuracy of theoretical models by directly examining experience as a moderator.

  View details for DOI 10.1007/s10865-017-9862-y

  View details for Web of Science ID 000415166600014

  View details for PubMedID 28631102

• Comparative Optimism and Event Skewness JOURNAL OF BEHAVIORAL DECISION MAKING Rose, J. P., Aspiras, O., Vogel, E., Haught, H., Roberts, L. 2017; 30 (2): 236–55

  View details for DOI 10.1002/bdm.1940

  View details for Web of Science ID 000397999600008

• Perceptions of Perfection: The Influence of Social Media on Interpersonal Evaluations BASIC AND APPLIED SOCIAL PSYCHOLOGY Vogel, E. A., Rose, J. P. 2017; 39 (6): 317–25

  View details for DOI 10.1080/01973533.2017.1356303

  View details for Web of Science ID 000422907400005

• The Influence of Early Experiences and Adult Attachment on the Exhibition of the Sexual Double Standard SEXUALITY AND CULTURE Zaikman, Y., Vogel, E. A., Vicary, A. M., Marks, M. J. 2016; 20 (3): 425–45

  View details for DOI 10.1007/s12119-015-9332-z

  View details for Web of Science ID 000411932600001

• Self-reflection and interpersonal connection: Making the most of self-presentation on social media Translational Issues in Psychological Science Vogel, E. A., Rose, J. P. 2016; 2 (3): 294-302

  View details for DOI 10.1037/tps0000076

• Who compares and despairs? The effect of social comparison orientation on social media use and its outcomes PERSONALITY AND INDIVIDUAL DIFFERENCES Vogel, E. A., Rose, J. P., Okdie, B. M., Eckles, K., Franz, B. 2015; 86: 249–56

  View details for DOI 10.1016/j.paid.2015.06.026

  View details for Web of Science ID 000360255000043

• Social Comparison, Social Media, and Self-Esteem PSYCHOLOGY OF POPULAR MEDIA CULTURE Vogel, E. A., Rose, J. P., Roberts, L. R., Eckles, K. 2014; 3 (4): 206–22

  View details for DOI 10.1037/ppm0000047

  View details for Web of Science ID 000438563100004