Date of Award


Document Type

Doctoral Research Project

Degree Name

Doctor of Psychology (PsyD)



First Advisor

Vida L. Tyc

Second Advisor

Patrick J. Aragon

Third Advisor

Theodore G. Petersen

Fourth Advisor

Robert A. Taylor


Given the established relationship between trauma and tobacco use, the increased use of Electronic Nicotine Delivery Systems (ENDS), and the research identifying numerous health risks to users of ENDS, examining the relationship between trauma and the use of these products is critical. This study examined trauma survivors’ health risk perceptions of ENDS use on their smoking and vaping behaviors. A total of 126 trauma survivors were included in the study and ranged in age from 18-64 years and were primarily male. In this study’s sample, the majority of participants were “current dual users” of both cigarettes and ENDS products (n = 96, 76.2%). The results of this study indicated that a proportion of participants endorsed experiencing all ten traumatic events (n = 41; 32.5%), and most reported experiencing more than seven events (M = 7.24; SD = 2.78). Of the trauma variables assessed, those who experienced more trauma were more likely to be current dual users than participants with exposure to less trauma. Current dual users in the sample were also more likely to have higher health risk perceptions than participants in the other smoking/vaping groups. The finding that trauma survivors continue to concurrently use ENDS and cigarettes despite their awareness of the perceived increased health risks, suggests that other factors beyond perceptions of health risk may drive their smoking and vaping behaviors. Most trauma survivors also endorsed smoking (n = 98; 77.8%) and vaping to cope with their trauma(s) (n = 84, 66.7%). Additionally, 63.5% of trauma survivors reported that they ‘agreed’ or ‘strongly agreed’ that ENDS use is an effective smoking cessation method (n = 80). Interventions that promote more adaptive coping to replace smoking and vaping in this high-risk population are warranted.


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