Dependence on E‐Cigarettes and Cigarettes in a Cross‐Sectional Study of U.S. Adults

Summary of Study

Bottom Line: Comparing the dependence of cigarettes versus e-cigarettes across a variety of different variables demonstrates that in every comparison, e-cigarette use was associated with significantly less dependence than cigarette smoking. These findings suggest that not only are e-cigarettes less addicting than cigarettes but also that smokers who transition to e-cigarettes may find it easier to subsequently quit e-cigarettes should they try to do so.

Some commentators have expressed concern about the potential of e-cigarettes to cause or perpetuate nicotine dependence. However, in this study, few e-cigarette users scored as highly dependent on e-cigarettes, while most smokers were highly dependent on cigarettes.

Multiple analyses showed that, whether they were using one or both products, users were less dependent on e-cigarettes than on traditional combusted cigarettes. These findings were consistent with previous studies, and suggest that e-cigarettes have less potential than conventional combusted cigarettes to produce dependence. This conclusion suggests that individuals who switch from smoking to e-cigarettes can reduce their nicotine dependence as well as their health risks.

The finding that e-cigarettes are less addicting than cigarettes held across multiple subpopulations of users, whether stratified by daily vs. non-daily use, or by current or former usage, and whether analyzed within-persons or between persons. In every case, dependence was significantly lower on e-cigarettes than on cigarettes, usually meaningfully so.

Among dual users, dependence was significantly lower on e-cigarettes compared to cigarettes. Whereas 48% of the scores for cigarette smoking were above 3.0, the mid-point of the dependency scale, only 8% of e-cigarette scores reached this threshold.

The majority of e-cigarette dependence scores (64%) were 1.5 or less, suggesting denial of dependence symptoms, a range seen in less than 13% of the cigarette-dependence scores. Dependence on e-cigarettes was also lower than dependence on smoking among daily users of each product, and among non-daily users of each.

Among former dual users, comparisons showed that residual dependence was significantly lower on e-cigarettes. Among current users, the mean dependence on e-cigarettes is significantly less than dependence on cigarettes among both daily and non-daily users.

Among e-cigarette users, the highest-rated e-cigarette dependence was seen among the e-cigarette users who had recently quit smoking, especially among those using e-cigarettes daily. This finding suggests that smokers might transition to exclusive e-cigarette use by transferring their dependence to e-cigarettes instead.

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Feature Charticle

Comparisons of Dependence on Cigarettes and E-Cigarettes

Addiction

Findings:

  • Mean dependence on e-cigarettes is significantly less than dependence on cigarettes among both daily and non-daily users. 
  • The finding that e-cigarettes are less addicting than cigarettes held across multiple subpopulations of users, with dependence significantly lower on e-cigarettes than on cigarettes in every case, usually meaningfully so.
  • These findings were consistent with previous studies, and suggest that e-cigarettes have less potential than conventional combusted cigarettes to produce dependence

Access the full study here