Previous studies had explored the associations between e-cigarette use and alcohol use problems, yet they did not fully consider e-cigarette use contexts. This longitudinal study conducted a prospective examination of e-cigarette use contexts and alcohol use problems among college students. College e-cigarette users at three public universities from Fall 2019 to Fall 2020 were included ( = 377). A linear mixed model with a random intercept and random slope was employed to examine the longitudinal associations. Higher frequencies of e-cigarette use ( = 0.38, < 0.001), being hooked on e-cigarettes ( = 0.96, < 0.01), using e-cigarettes for socializing purposes ( = 0.58, < 0.05), and more occasions of co-using e-cigarettes with alcohol ( = 0.05, < 0.001) were linked to more alcohol use problems. Intervention efforts should incorporate comprehensive screening that includes both e-cigarette and alcohol use, enhance awareness of peer influence, and provide at-risk populations with education regarding the potential synergistic effects of e-cigarette and alcohol co-use.
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