Abstract
E-cigarettes are often considered less addictive than traditional cigarettes. This study aimed to assess patterns of e-cigarette use and to compare nicotine dependence among cigarette and e-cigarette users in a group of highly educated young adults. From 3002 healthy adults, a representative group of 30 cigarette smokers, 30 exclusive e-cigarette users, and 30 dual users were recruited. A 25-item questionnaire was used to collect information related to the patterns and attitudes towards the use of cigarettes and e-cigarettes. The Fagerström test for nicotine dependence (FTND) and its adapted version for e-cigarettes were used to analyze nicotine dependence in each of the groups. The nicotine dependence levels measured with FTND were over two times higher among e-cigarette users (mean 3.5) compared to traditional tobacco smokers (mean 1.6; p < 0.001). Similarly, among dual users, nicotine dependence levels were higher when using an e-cigarette (mean 4.7) compared to using traditional cigarettes (mean 3.2; p = 0.03). Habits and behaviors associated with the use of e-cigarettes did not differ significantly (p > 0.05) between exclusive e-cigarette users and dual users. The findings suggest that e-cigarettes may have a higher addictive potential than smoked cigarettes among young adults.
Highlights
Nicotine is a highly addictive substance and adolescents and young adults may be at high risk of addiction [1,2]
Habits and behaviors associated with the use of e-cigarettes, including nicotine content in the e-liquid, e-liquid consumption, type of e-liquid used, and the number of e-cigarettes used, did not differ significantly (p > 0.05) between e-cigarette users and dual users
The high levels of nicotine dependence observed among young adult e-cigarette users compared to smokers in our study suggest this group may be at high risk of addiction
Summary
Nicotine is a highly addictive substance and adolescents and young adults may be at high risk of addiction [1,2]. Nicotine withdrawal effects such as irritability, anxiety, poor concentration, memory impairment, and insomnia can occur after cessation of chronic nicotine use [3]. Electronic cigarettes (e-cigarettes) are a relatively new form of nicotine delivery device and the prevalence of their use is rapidly growing in many countries [7,8,9]. E-cigarettes have been suggested as a way to reduce nicotine dependence and have been reported to be less addictive than traditional cigarettes [10]. There have been numerous reports of people who become addicted to
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