A new study found, for the first time, that vaping reported from memory by college students is significantly less than vaping recorded with real-time measures.
The research, led by Dr. Anne Buu and colleagues from the University of Texas Health Science Center in Houston, in collaboration with UW-CTRI Director of Research Dr. Megan Piper, was published in Nicotine & Tobacco Research.
“What came out of this is that what we think we do and what we actually do are very different,” Piper said.
It was the first study to find that college students tended to vape much more than they thought—nine times more. While Piper expected a discrepancy, she didn’t think it’d be that big.
“But it’s difficult with e-cigarettes to figure out what a ‘Use Event’ is,” Piper said. “With a cigarette, you smoke it until it’s done. With e-cigarettes, some take a couple hits or puffs and that’s it. My guess is, they remember the times when their use is longer or more intentional, not the quick or automatic ones.”
It’s akin to the difference between tracking every potato chip you eat versus sitting down with a huge bowl while watching TV and not really paying attention to how many you’re eating.
Piper said some may underreport for other reasons. “We use all sorts of schemas or mental shortcuts to understand our world. We think we’re healthy, we think we eat four helpings of vegetables. But when we actually measure it, it’s only two.” Or maybe one of the “helpings” of veggies is actually two shards of mushrooms on a slice of pizza.
“We see the goal,” she said, like having one serving of ice cream. “But then when we look at the size of the bowl, it’s actually five servings.”
Human error and fuzzy memory could also be factors. “As a species, we’re terrible estimators,” Piper said. Ever try to estimate the number of gumdrops in a jar?
“It’s not until we start keeping track of what we do that we can actually change.”
The study team established 10 to 15 puffs on an e-cigarette or 10 minutes of vaping as a use event, somewhat like the use of one cigarette. “But if the study participants never smoked,” Piper said, “and are native vapers, then they’ve never used their product like that. Some have never taken 15 puffs in one sitting. There can be very different use patterns.”
There can also be variability in the length and depth of a drag or puff, Piper said. Researchers also concluded that the more dependent a college student is on vaping, the more they tended to underestimate how much they vape. Flavors can also entice people to vape.
“A lot of factors can drive use, but I think dependence was one of the key factors driving the mismatch” between the self-report and real-time tracking, Piper said.
UW-CTRI has used tools for real-time vaping reporting for past studies like Exhale and Options, and plans to continue doing so in future research.
Of course, even real-time reporting could be underestimated.
UW-CTRI researchers have considered testing a device that records use puff by puff. But such a measurement tool would need to be brand agnostic and affordable.
Piper said she was grateful to be part of the research. “Dr. Anne Buu and her colleagues have worked with our Exhale study data as well, and she has been a fantastic collaborator and methodology expert.”
Yang JJ, Ou T-S, Lin H-C, Nam JK, Piper ME, Buu A. (2023) Retrospective and Real-Time Measures of the Quantity of E-Cigarette Use: An Ecological Momentary Assessment Study. Nicotine & Tobacco Research. Online June 16, 2023.