Measuring Poly-tobacco Product Use with Ecological Momentary Assessment

Abstract

Objectives: Poly-tobacco product use is common among tobacco users, but it is challenging to assess patterns of use in real-life contexts. The objective of this study is to determine whether intensive longitudinal methods are feasible for assessing concurrent use of multiple tobacco products. Methods: Overall, 28 participants completed a baseline questionnaire and 7 days of ecological momentary assessment data collection, including end-of-day, random, and real-time reporting. Results: When estimating use of cigarettes, vaping products, and other products individually, there were moderate correlations between baseline questionnaire estimates, end-of-day estimates, and random estimates (ρ= 0.379–0.640); however, daily totals of all products combined were poorly correlated (ρ = 0.198–0.461). Baseline questionnaire estimates were higher than random estimates for each product (median difference 1.5–7.0 products per day). End-of-day estimates were more consistent with the baseline questionnaire. There was low compliance with real-time product use reports. Conclusions: Random or daily reporting are feasible for poly-tobacco use assessment, but methods are needed to reconcile differences in estimates. Accurate measurement of poly-tobacco product use is needed to assess health impacts and inform policy.