(PS1-37) Nicotine Dependence, Perceptions of Use, and Affective Vulnerability Among Dual Users Who Report Relapse: Implications for Targeted Treatment

Introduction: Most adults who use electronic cigarettes (e-cig) in the US also use combustible cigarettes (CC; 68.1%). Nearly two-thirds of dual users (71.1%) desire to quit both products and cessation attempts for both products is common among dual users. Yet, discontinuation of CC and e-cig is rare, with only 7-11% of established dual users reporting comprehensive cessation. Yet, there is little understanding for the behavioral and psychological phenotype profile of dual users who relapse when they attempt to quit CC or e-cigs.

Method: The current study examined group differences in dependence, barriers to cessation, and affective vulnerability across dual users’ quit history. Participants included 388 (53.4% female; M_age = 37.8 years, SD = 9.7; 90.5% White) adult dual CC and e-cig users recruited through an online survey platform.

Results: One-way ANOVAs were conducted to examine differences across (1) dual users who had never attempted to quit either product (N = 48), (2) dual users who reported a failed CC quit attempt or a failed e-cig attempt (N = 133), and (3) dual users who reported a failed attempt to quit both products (N = 207). Dual users who reported a failed attempt to quit both products reported greater CC and ENDS dependence (FTND: F[2, 385]= 8.826, p≤.001; PSECDI: F[2, 385]=18.225, p≤.001), perceived barriers to CC and ENDS cessation (BCS: F[2, 384]= 17.240, p≤.001; E-BCS: F[2, 381]=24.270, p≤.001), and affective vulnerability (OASIS: F[2, 383]=18.232, p≤.001; ODSIS: F[2, 383]=14.925, p≤.001); AS: F[2, 383]=18.156, p≤.001; DERS: F[2, 383]=22.126, p≤.001)  relative to those who had never attempted to quit and those who reported a failed quit attempt for a single product. Notable, those who had never attempted to quit and those who reported a failed attempt of a single product did not differ on CC or e-cig dependence, e-cig barriers to cessation, or SSASI.

Discussion: These data suggest that dual users who exhibit behavioral and psychological profiles of greater dependence, report stronger perceptions that quitting will be difficult, and experience more severe negative affective vulnerabilities are at risk for relapse of both products following a quit attempt. From a precision medicine approach, efforts are needed to support comprehensive cessation among those who report a past history of quit difficulty by targeting risk factors known to interfere with cessation (i.e., beliefs about quitting and affective vulnerability)