A longitudinal study of the association between e-cigarette use contexts and alcohol use problems among college students

<b>Objective:</b> Previous studies had explored the associations between e-cigarette use and alcohol use problems, yet they did not fully consider e-cigarette use contexts. This longitudinal study conducted a prospective examination of e-cigarette use contexts and alcohol use problems among college students. <b>Participants:</b> College e-cigarette users at three public universities from Fall 2019 to Fall 2020 were included (<i>N</i> = 377). <b>Methods:</b> A linear mixed model with a random intercept and random slope was employed to examine the longitudinal associations. <b>Results:</b> Higher frequencies of e-cigarette use (<i>β</i> = 0.38, <i>p</i> < 0.001), being hooked on e-cigarettes (<i>β</i> = 0.96, <i>p</i> < 0.01), using e-cigarettes for socializing purposes (<i>β</i> = 0.58, <i>p</i> < 0.05), and more occasions of co-using e-cigarettes with alcohol (<i>β</i> = 0.05, <i>p</i> < 0.001) were linked to more alcohol use problems. <b>Conclusions:</b> Intervention efforts should incorporate comprehensive screening that includes both e-cigarette and alcohol use, enhance awareness of peer influence, and provide at-risk populations with education regarding the potential synergistic effects of e-cigarette and alcohol co-use.