Dependence on E‐Cigarettes and Cigarettes in a Cross‐Sectional Study of U.S. Adults
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.
Access the full study here.
- 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.