Abstract
BackgroundWhile rates of e-cigarette use (‘vaping’) continue to potentiate concern, there is limited data on common symptoms of e-cigarette dependence among young adults who vape. This study sought to critically explore how young adults experience, manifest, and conceptualize vaping dependence symptoms in their everyday lives.MethodsBetween June 2018 and 2019, in-depth qualitative interviews were conducted with 62 young adults who use e-cigarettes (aged 18–25) and live in Southern California. We explored participants’ product preferences, daily e-cigarette use patterns, vaping history, withdrawal experiences, and quit attempts or periods of cessation. We used a thematic analysis approach to interpret the transcripts.ResultsYoung adults discussed nine dimensions of vaping dependence that were organized into two categories: 1) general nicotine dependence symptoms, and 2) unique dependence symptoms related to vaping. Nicotine dependence symptoms included cravings and urgency to use, increased use to achieve desired effects, and unsuccessful quit attempts and withdrawal. Symptoms unique to vaping dependence included greater nicotine consumption due to accessibility and lack of restrictions, habitual vaping, inability to track vaping frequency, immediate gratification and comfort, social acceptability and norms, and awareness of vaping dependency.ConclusionsIn addition to nicotine dependence symptoms that have been characterized for other tobacco products, young adult e-cigarette users described unique symptoms of vaping dependence that necessitate the need for more refined measures. All dimensions of vaping dependence should be considered in discussions of policies as well as treatment and education efforts intended to protect young people from e-cigarette dependence.
Highlights
IntroductionThe prevalence of e-cigarette use (i.e., ‘vaping’) among youth and young adults remains high, with more than 1 in 5 youth and more than 1 in 6 young adults (aged 19–28 years) reporting past 30 day use in 2019 [1, 2]
Despite nationwide prevention efforts, the prevalence of e-cigarette use (i.e., ‘vaping’) among youth and young adults remains high, with more than 1 in 5 youth and more than 1 in 6 young adults reporting past 30 day use in 2019 [1, 2]
All study procedures were approved by the University of Southern California (USC) Institutional Review Board
Summary
The prevalence of e-cigarette use (i.e., ‘vaping’) among youth and young adults remains high, with more than 1 in 5 youth and more than 1 in 6 young adults (aged 19–28 years) reporting past 30 day use in 2019 [1, 2]. A text analysis of tweets related to nicotine effects, dependence, and withdrawal among JUUL users found that those who vaped discussed strong physiological withdrawal symptoms due to e-cigarettes, desires to quit vaping, and accounts of feeling ‘addicted to’ or ‘dependent on’ their JUUL device [13] While these findings provide initial evidence that some individuals who use e-cigarettes may experience dependence, research among young adults is sparse. The studies available have generally utilized surveys that were originally validated in samples of primarily adult, combustible cigarette users, and which do not address the potentially unique expression of nicotine dependence that may occur for those who vape [14, 15]. This study sought to critically explore how young adults experience, manifest, and conceptualize vaping dependence symptoms in their everyday lives
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