Development of a Questionnaire for Assessing Dependence on Electronic Cigarettes Among a Large Sample of Ex-Smoking E-cigarette Users

Abstract

Introduction: Electronic cigarettes (e-cigs) are becoming increasingly popular, but little is known about their dependence potential. This study aimed to assess ratings of dependence on electronic cigarettes and retrospectively compare them with rated dependence on tobacco cigarettes among a large sample of ex-smokers who switched to e-cigs. Methods: A total of 3,609 current users of e-cigs who were ex-cigarette smokers completed a 158-item online survey about their e-cig use, including 10 items designed to assess their previous dependence on cigarettes and 10 almost identical items, worded to assess their current dependence on e-cigs (range 0-20). Results: Scores on the 10-item Penn State (PS) Cigarette Dependence Index were significantly higher than on the comparable PS Electronic Cigarette Dependence Index (14.5 vs. 8.1, p < .0001). In multivariate analysis, those who had used e-cigs longer had higher e-cig dependence scores, as did those using more advanced e-cigs that were larger than a cigarette and had a manual button. Those using zero nicotine liquid had significantly lower e-cig dependence scores than those using 1-12 mg/ml, who scored significantly lower than those using 13 or greater mg/ml nicotine liquid (p < .003). Conclusions: Current e-cigarette users reported being less dependent on e-cigarettes than they retrospectively reported having been dependent on cigarettes prior to switching. E-cig dependence appears to vary by product characteristics and liquid nicotine concentration, and it may increase over time.

Electronic Cigarettes in Germany: Patterns of Use and Perceived Health Improvement

“…We cannot confirm the finding that dual users have higher Fagerström scores than ex-smokers. We used the modified Fagerström test instead of the newly developed Penn State (Electronic) Cigarette Dependence Index [54] because there exists a better comparison of the 2 German surveys. The dependence risk of e-cigarettes with liquid containing nicotine is in fact assessed as moderate, but substantially less than that of tobacco products.…”

Evaluación de los niveles de dependencia de la nicotina en usuarios de cigarrillos electrónicos

“…La evidencia reciente muestra que los niveles de nicotina medidos en plasma y en saliva son similares a los de fumadores e incluso más altos que los niveles observados en usuarios de terapia de sustitución de nicotina (Marsot y Simon, 2015). Es más, los niveles bajos de dependencia de la nicotina y el incremento en el número de minutos entre el despertar y el primer uso autoinformados por los usuarios de cigarrillos electró-nicos explican los niveles menores de dependencia de la nicotina en este grupo, en comparación con fumadores de tabaco (Foulds et al, 2015). El objetivo de este estudio es explorar los niveles de dependencia de la nicotina en una muestra de usuarios experimentados con el uso de cigarrillos electrónicos (n = 39; hombres = 77%) y comparar dichos resultados con fumadores de tabaco (n = 42; hombres = 57%).…”

Electronic cigarettes: The nicotyrine hypothesis

“…Health advocates also have raised concerns about the potential for e-cigs to aerosolize illicit drugs, cause fires, re-normalize smoking type behavior, and act as a gateway deug, addicting non-smoking youth to nicotine and leading them to become smokers. On the other hand, e-cig aerosols clearly contain fewer and less concentrated noxious compounds than cigarette smoke, and first and second generation e-cigs seem to reduce conventional measures of dependence [2][3][4][5].…”

“…Health advocates also have raised concerns about the potential for e-cigs to aerosolize illicit drugs, cause fires, re-normalize smoking type behavior, and act as a gateway deug, addicting non-smoking youth to nicotine and leading them to become smokers. On the other hand, e-cig aerosols clearly contain fewer and less concentrated noxious compounds than cigarette smoke, and first and second generation e-cigs seem to reduce conventional measures of dependence [2][3][4][5].Investigators report many contradictory observations about the efficacy of first and second-generation e-cigs as nicotine delivery devices. One group reported that e-cigs did not deliver nicotine to smokers [6,7], but later found that vapers using their own e-cigs did absorb nicotine [8].…”