INTRODUCTION prior studies on the association between the intensity of and motives for vaping e-cigarettes have highlighted the psychological dynamics of motivational changes, but less about how vaping motives may shift as a function of risk perceptions exacerbated by unanticipated events. This study frames the COVID-19 pandemic as an exacerbating threat to pulmonary health, and tests how e-cigarette users' risk perceptions of COVID-19 are related to different motives for vaping and ultimately the intensity of e-cigarette use. METHODS an online survey of e-cigarette users in the U.S. (n=562) was conducted during April 2020 when much of the U.S. was under "lockdown" conditions. We distinguished three types of vaping motives (health, socialization, and dependence) and established the classification with confirmatory factor analysis. Structural equation modeling was conducted for path analyses and mediation tests. RESULTS all three vaping motives were significantly associated with greater use intensity. A heightened risk perception of e-cigarette users' vulnerability to COVID-19 was inversely associated with use intensity (-.18, p<.01) and health motives for vaping (-.27, p<.001), but not associated with socialization and dependence motivations. Health motives for vaping mediated 35% of the association between COVID-19 risk perceptions and use intensity. CONCLUSIONS our findings indicate that risk perceptions of exacerbated threats may reduce e-cigarette use directly, and also indirectly through shifting certain types of motivations for vaping. Beyond elucidating the relational dynamics between vaping psychology and health risks, these results also indicate health professionals may leverage the pandemic to promote nicotine cessation or reduced use. IMPLICATION Little is known about how vaping motives shift after unanticipated events such as pandemics. This study contributes to knowledge of how the use of e-cigarettes is motivated by different dimensions of rationales and exogenous risks. Exploiting the emergence of the COVID-19 pandemic, we found risk perceptions are associated with the intensity of e-cigarette use indirectly specifically through health motivations. Risk perceptions are not associated with socialization and dependence motives for vaping.
Vaping in a Time of Pandemics: Risk Perception and Motivations for Electronic Cigarette Use.