# Effect of E-cigarette Use and Social Network on Smoking Behavior Change: An agent-based model of E-cigarette and Cigarette Interaction

**Authors:** Yang Qin, Rojiemiahd Edjoc, Nathaniel D Osgood  
**arXiv:** [1905.03611](https://arxiv.org/abs/1905.03611)  
**Date:** 2019-05-03  
**Summary page:** https://www.summarizepaper.com/en/paper/1905.03611v1/

## Key points

- Smoking remains one of the biggest public health threats
- Use of electronic cigarettes (ECig) has increased dramatically over the last decade
- ECig use impacts smoking behavior through multiple pathways
- ECigs can be used as a means to quit cigarettes and lower risk of relapse
- ECigs serve as an alternative nicotine delivery device to cigarettes
- Visible use of nicotine in ECigs can lead to imitative smoking behavior
- ECigs are seen as a gateway technology that can build nicotine tolerance and initiate smoking
- Researchers built an agent-based model (ABM) to examine the effects of ECig use on smoking behavior change
- Social networks play a role in initiation of smoking and ECig use
- The simulation suggests that ECig use reduces prevalence of current smokers (PCS)
- Social networks increase prevalence of current ECig users (PCEU)
- Factors such as social networks and behavioral drivers should be considered when designing interventions or policies related to tobacco control.

## Summary

Despite a general reduction in smoking in many areas of the developed world, it remains one of the biggest public health threats. As an alternative to tobacco, the use of electronic cigarettes (ECig) has been increased dramatically over the last decade. ECig use is hypothesized to impact smoking behavior through several pathways, not only as a means of quitting cigarettes and lowering risk of relapse but also as both an alternative nicotine delivery device to cigarettes and as a visible use of nicotine that can lead to imitative behavior in the form of smoking. Additionally, ECigs are seen as a gateway nicotine delivery technology that can build high levels of nicotine tolerance and pave the way for initiation of smoking. In order to examine the effects of ECig use on smoking behavior change, researchers built an agent-based model (ABM) of smoking and ECig use. The model also explored the impact of social networks on the initiation of smoking and ECig use. The findings from this simulation suggest that the use of ECigs generates substantially lower prevalence of current smokers (PCS), demonstrating its potential for reducing smoking rates and lowering the risk of relapse. Additionally, this study highlights important factors such as social networks and behavioral drivers that should be considered when designing interventions or policies related to tobacco control. Furthermore, proximity-based influences within social networks were found to increase the prevalence of current ECig users (PCEU). Overall, this study provides valuable insights into how ECig use can affect smoking behavior change by emphasizing its potential benefits in terms of reducing smoking rates and lowering relapse risks.