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Host–agent–vector–environment measures for electronic cigarette research used in NIH grants
  1. Mary L Garcia-Cazarin1,
  2. Rachel J Mandal1,
  3. Rachel Grana2,
  4. Kay L Wanke1,
  5. Helen I Meissner1
  1. 1 Office of Disease Prevention, National Institutes of Health, Bethesda, Maryland, USA
  2. 2 Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
  1. Correspondence to Dr Helen I Meissner, Office of Disease Prevention, National Institutes of Health, 6100 Executive Blvd., Suite 3B01, Bethesda, MD 20892-7530, USA; Hm36d{at}


Objective The purpose of this study is to describe the focus and comprehensiveness of domains measured in e-cigarette research.

Methods A portfolio analysis of National Institutes of Health grants focusing on e-cigarette research and funded between the fiscal years 2007 and 2015 was conducted. Grant proposals were retrieved using a government database and coded using the Host–Agent–Vector-Environment (HAVE) model as a framework to characterise the measures proposed. Eighty-one projects met the criteria for inclusion in the analysis.

Results The primary HAVE focus most commonly found was Host (73%), followed by Agent (21%), Vector (6%) and Environment (0%). Intrapersonal measures and use trajectories were the most common measures in studies that include Host measures (n=59 and n=51, respectively). Product composition was the most common area of measurement in Agent studies (n=24), whereas Marketing (n=21) was the most common (n=21) area of Vector measurement. When Environment measures were examined as secondary measures in studies, they primarily focused on measuring Peer, Occupation and Social Networks (n=18). Although all studies mentioned research on e-cigarettes, most (n=52; 64%) did not specify the type of e-cigarette device or liquid solution under study.

Conclusions This analysis revealed a heavy focus on Host measures (73%) and a lack of focus on Environment measures. The predominant focus on Host measures may have the unintended effect of limiting the evidence base for tobacco control and regulatory science. Further, a lack of specificity about the e-cigarette product under study will make comparing results across studies and using the outcomes to inform tobacco policy difficult.

  • electronic nicotine delivery devices
  • prevention
  • non-cigarette tobacco products
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  • Contributors All authors contributed equally.

  • Funding The NIH Office of Disease Prevention and the National Cancer Institute provided support for this analysis.

  • Disclaimer The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health (NIH) or the Food and Drug Administration (FDA).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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