"Essentially, All Models are Wrong, but Some Are Useful": A Preliminary Conceptual Model Of Co-Occurring E-Cig and Alcohol Use.

PURPOSE OF REVIEW: As prevalence rates of electronic cigarette (e-cig) use increase, researchers and clinicians should not only be paying careful attention to the direct health effects of e-cigs, but also the potential impact e-cigs may have on alcohol use behaviors. We review the current state of the literature and propose a conceptual model for the relationship between e-cig and alcohol use, including important consequences, mechanisms, and moderators of this relationship.

RECENT FINDINGS: The model is based in emerging literature examining the direct relationship between e-cig and alcohol use, as well as indirect evidence concerning potential mechanisms from research on cigarette and alcohol use. Overall, research indicates a robust relationship between e-cig and alcohol use.

SUMMARY: We suggest that a relationship between e-cig use and alcohol use could be particularly problematic, especially for adolescents and for those with or at risk for alcohol use disorders. We hope the presented conceptual model can stimulate research in this area. We make research recommendations, including the need for more methodological rigor, including improved measurement of e-cig use, and expanding research to longitudinal and experimental designs.