Electronic cigarette use: comparing smokers, vapers, and dual users on characteristics and motivational factors

Abstract

INTRODUCTION This study examined vaping behaviour, precursors of vaping, and motivational differences between smokers, dual users and vapers. The objectives were to assess a) vaping characteristics and reasons for use, b) differences in motivational factors and behavioural precursors associated with e-cigarette use, and c) socio-demographic and motivational factors associated with electronic cigarette use. METHODS A cross-sectional survey among 259 vapers, 135 smokers, and 83 dual users was conducted in the Netherlands. The questionnaire, based on the I-Change Model, assessed demographics, smoking and vaping behaviour, quit attempt, attitudes towards e-cigarettes, social influences, self-efficacy about not to vape and intention to quit. RESULTS Vaping e-cigarettes was mostly started for health reasons. Less than 2% of the vapers had never used conventional cigarettes. Vapers reported most advantages of e-cigarettes whereas smokers were least convinced of them, encountered more modelling of vaping in their social environment and reported higher self-efficacy to control vaping. Older respondents and respondents with low levels of education and low income were more likely to use e-cigarettes instead of conventional cigarettes. CONCLUSIONS Although vaping was mostly started for health reasons, the use of the product was not strictly limited to (former) smokers. Health communication for non-smokers is needed to stress potential dangers. Both vapers and non-vapers encounter barriers for using e-cigarettes in difficult situations. If e-cigarettes are used as a smoking cessation tool, more information is needed to help users cope with these situations. For future interventions we recommend to take potential motivational differences among low and high income and educated groups into account.

Electronic cigarette use and psychological distress in the Native Hawaiian and Pacific Islander adults compared with other racial/ethnic groups: Data from the National Health Interview Survey, 2014

“…In the general NHIS, we included adults who self‐identified as non‐Hispanic White, non‐Hispanic Black or African–American, non‐Hispanic Asian (hereafter referred to as NHPI, Whites, Blacks, and Asians), and Hispanic, and excluded those with multiple race/no primary race selected to avoid non‐identification of NHPI. In both surveys, we excluded participants who were both current E‐cigarette users and conventional cigarette smokers, as their characteristics may differ from those of E‐cigarette users only (Schoren, Hummel, & de Vries, ). In both surveys, participants who responded “refused,” “don't know,” and “not ascertained” were coded as missing.…”

“…Despite these limitations, this study provides several new contributions to research. In this study, dual users (E‐cigarettes and cigarettes) were removed from consideration because studies have shown that this group has characteristics that differ from those of E‐cigarette users, and because E‐cigarettes are sometimes used as a cessation tool among current smokers (Schoren et al, ). Consequently, we were not able to establish differences between dual users and E‐cigarette users across race/ethnicity.…”

A Combination of Factors Related to Smoking Behavior, Attractive Product Characteristics, and Socio-Cognitive Factors are Important to Distinguish a Dual User from an Exclusive E-Cigarette User

“…Research has presented several differences between exclusive e-cigarette users and dual users, but the variability in results and definitions used makes it difficult to compare these differences [19]. Review of relevant literature has identified four clusters of differences between dual users and e-cigarette users [9,13,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34]. While previous research looked at differences between dual users and exclusive e-cigarette users on an individual factor level or combined two clusters in an analysis, the goal of our study is to provide aggregated data by combining all the clusters of factors identified with machine learning [9,13,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34].…”

“…Risk perception differed between dual users and exclusive e-cigarette users [19]. More often, partners, family, friends, and colleagues of e-cigarette users were fellow e-cigarette users [24,30]. E-cigarette users also had less desire for cigarette smoking than dual users, and they found it easier than dual users not to smoke [23,24,30].…”

Are ‘dual users’ who smoke and use e-cigarettes interested in using varenicline to stop smoking altogether, and can they benefit from it? A cohort study of UK vapers

“…Compared with smokers who switch to vaping completely, dual users were reported to have lower education and income4 and to be more likely to have smoking peers 5. They recourse to cigarettes in stressful situations and when rapid nicotine uptake is required,6 7 but also in hedonic situations 8.…”