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Alcohol and tobacco are significant public health threats, which are magnified during simultaneous use (i.e., under the effects of both substances). E-cigarettes are not a harmless alternative to combustible cigarettes, yet the prevalence of e-cigarette use among college students rose 400% between 2017-2018. Additionally, around 60% of college students consumed alcohol in the past month. Simultaneous alcohol and nicotine use can result in an increased state of pleasure, which may affect rates of usage. The purpose of this study is to assess variations in patterns of e-cigarette use, outcome expectancies, and perceived pleasure from e-cigarettes as a function of alcohol use. This project is expanding on previous research that has linked hazardous alcohol consumption with greater expectancies for the simultaneous use of alcohol and e-cigarettes. Participants (N = 552; Mage = 23.57 years; 56.5% Female) were recruited on Amazon’s MTurk and completed measures of frequency/quantity of alcohol (Alcohol Use Disorders Identification Test) and nicotine (Penn State Nicotine Dependence Index) use, expectancies for simultaneous e-cigarette/alcohol use (Nicotine and Other Substances Interaction Expectancies-Revised), and perceived pleasure and frequency of simultaneous e-cigarette alcohol/use. After controlling for age, ethnicity, college enrollment, and nicotine dependence, separate linear regression models revealed that greater alcohol consumption was associated with greater expectancies for simultaneous use of e-cigarettes/alcohol and greater pleasure from simultaneous use (all ps < .015). Similarly, separate regressions revealed that as people engage in greater frequency of simultaneous use, they also report greater expectancies and greater pleasure for simultaneous use (all ps < .001). Examination of squared semipartial correlations revealed that frequency of simultaneous use was more strongly related to each outcome variable than alcohol consumption alone. Findings add to a growing body of knowledge on simultaneous e-cigarette/alcohol use and have implications for interventions to reduce both behaviors.



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Alcohol and E-Cigarette Simultaneous Use: The Role of Motivations and Expectancies