The Modified E-Cigarette Evaluation Questionnaire: Psychometric Evaluation of an Adapted Version of the Modified Cigarette Evaluation Questionnaire for Use With Adults Who Use Electronic Nicotine Delivery Systems

Abstract

Abstract Introduction The subjective experience of positive and negative effects likely contributes to e-cigarette use, and the Modified Cigarette Evaluation Questionnaire (MCEQ) previously has been adapted to assess the reinforcing and aversive effects of vaping. However, the psychometric properties of the MCEQ for use with e-cigarettes have not been established. Aims and Methods We examined the psychometric properties of the Modified E-cigarette Evaluation Questionnaire (MECEQ) within a sample of 857 adults who recently used e-cigarettes in a smoking cessation attempt (52.4% male; 40.84 [12.25] years old; 62.8% non-Hispanic white; 22.4% daily e-cigarette users). Analyses included confirmatory factor analysis of the original structure, exploratory/confirmatory factor analyses to identify the alternate latent structure(s), internal consistency, measurement invariance, between-group differences, and test-criterion relationships with vaping-related outcomes. Results The original five-factor structure and a novel four-factor structure were supported. Each was scalar invariant across several participant subgroups (eg, current smoking status, daily vaping status). All multi-item subscales were internally consistent. Both versions detected several between-group differences. For example, current smokers reported stronger aversive effects than did exclusive e-cigarette users. Finally, adjusted relationships between both MECEQ versions and vaping-related outcomes provided evidence for concurrent validity. Conclusions The five-factor and four-factor versions of the MECEQ evidenced good-to-excellent internal consistency, scalar measurement invariance, and concurrent relationships with vaping-related outcomes. While both versions could be used to assess subjective vaping effects in adults with histories of cigarette smoking and vaping, additional research is needed to evaluate the applicability of these factor structures to other samples (eg, e-cigarette users with no smoking history, youth). Implications Although the MCEQ has been adapted in previously published studies to assess the subjective reinforcing and aversive effects of vaping, the psychometric foundation necessary for doing so had not been established. We showed that the MECEQ can be scored using the original five-factor MCEQ format or using a newly identified four-factor structure. Both versions evidenced construct validity, internal consistency, measurement invariance (permitting between-group comparisons), and concurrent validity with vaping-related outcomes. Results strengthen the interpretability of previously published work using the five-factor MCEQ structure and provide an alternative scoring approach for vaping-specific subjective effects.