All ETDs from UAB

Advisory Committee Chair

Peter Hendricks

Advisory Committee Members

Mark T Dransfield

Pavela Greg

Donald H Lein Jr

Michael Wells

Document Type


Date of Award


Degree Name by School

Doctor of Philosophy (PhD) School of Health Professions


There is surge increase in e-cigarettes among adult vulnerable population such as individuals with chronic lung disease (CLD). Currently, there is a lack of understanding of the factors that may lead to the increase use of e-cigarettes or susceptibility of ecigarette use among individuals who have a history of CLD. Thus, it is crucial to recognize the characteristics of the individuals with CLD and adults without CLD who are susceptible to using e-cigarettes because this may pave the way for the prevention and reduction of tobacco use by identifying the different factors and eventually targeting the related risk factors. In this dissertation, we assessed the characteristics of individuals with and without CLD who are susceptible to using e-cigarette or actual e-cigarette use and the influence of different factors. This dissertation is reported in three different papers. In the first paper, we sought to assess the association between CLD, and e-cigarette use and to decide whether binge drinking moderates this relationship. E-cigarette use appears to be more common among adults with self-reported CLD. We also found that binge drinking was positively associated with e-cigarette use, however, more numerous binge drinking episodes undermined the link between CLD and e-cigarette use. In the second paper, we iv assessed whether mental health condition explains the association between CLD and ecigarette use, and whether the association between CLD and e-cigarette use is conditional on the presence or absence of respiratory symptoms. The association between CLD and e-cigarette use may be due, in part, to poorer mental health among individuals with CLD. our analyses did not indicate a statistically significant interaction between chronic lung disease and respiratory symptoms in the likelihood of e-cigarette use. These findings provide preliminary evidence that improving the mental health of individuals with CLD could reduce e-cigarette use in this population. In the third paper, we looked at the association between clinical diagnosis CLD status and the susceptibility of e-cigarette and, to see if behavioral or environmental factors influence this relationship. We found out that the susceptibility to using e-cigarettes was higher among adults without CLD than those with. Warning label, receiving discounts or coupons, drinking was associated with an increased likelihood of susceptibility to using e-cigarettes independent of CLD status. However, our analyses did not indicate a statistically significant interaction between CLD and any of the environmental or behavioral factors in the susceptibility of using e-cigarette use. Longitudinal investigations are demanded to better evaluate the sequential relationship between CLD, substance use, environmental factors, and the susceptibility to using e-cigarettes among individuals with CLD to prevent further lung damage.



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