Abstract
BackgroundE-cigarettes are the most popular aid to smoking cessation attempts in England and the USA. This research examined associations between e-cigarette device characteristics and patterns of use, tobacco-smoking relapse, and smoking abstinence.MethodsA convenience sample of 371 participants with experience of vaping, and tobacco-smoking abstinence and/or relapse completed an online cross-sectional survey about e-cigarettes. Factors associated with smoking relapse were examined using multiple linear and logistic regression models.ResultsMost participants were self-reported long-term abstinent smokers (86.3%) intending to continue vaping. Most initiated e-cigarette use with a vape pen (45.8%) or cig-a-like (38.7%) before moving onto a tank device (89%). Due to missing data, managed through pairwise deletion, only around 70 participants were included in some of the main analyses. Those using a tank or vape pen appeared less likely to relapse than those using a cig-a-like (tank vs. cig-a-like OR = 0.06, 95% CI 0.01–0.64, p = 0.019). There was an inverse association between starting self-reported e-cigarette liquid nicotine concentration and relapse, interacting with device type (OR = 0.79, 95% CI 0.63–0.99, p = 0.047), suggesting that risk of relapse may have been greater if starting with a low e-cigarette liquid nicotine concentration and/or cig-a-like device. Participants reported moving from tobacco-flavored cig-a-likes to fruit/sweet/food flavors with tank devices.ConclusionsKnowledge of how people have successfully maintained tobacco-smoking abstinence using vaping could help other tobacco smokers wishing to quit tobacco smoking through vaping.
Highlights
E-cigarettes are the most popular aid to smoking cessation attempts in England and the USA
Relapse appeared more common among those using a cig-a-like, compared with a vape pen or a mod and tank (Table 2). Those using a mod and tank device (n = 16/98), or a vape pen (n = 40/98), on initiation were significantly less likely to relapse than those using a cig-a-like (n = 42/98)
Our results suggest that in practice vapers who reported higher cigarettes per day (CPD) generally start with higher nicotine strength e-liquids, but that perhaps some smokers are starting on strengths insufficient for their needs
Summary
E-cigarettes are the most popular aid to smoking cessation attempts in England and the USA. E-cigarette use, known as “vaping,” is thought to be less harmful than tobacco smoking [1] and e-cigarettes are the most popular aid to smoking cessation attempts in England [2] and the USA [3]. First-generation devices are typically “cig-a-likes” designed to look and feel like tobacco cigarettes and use prefilled cartridges [8]. Third-generation devices use re-fillable tanks and allow modifications to the voltage and/or wattage output, improving performance and allowing a tailored user experience. Pod devices, designed to combine the simplicity of cig-a-likes with the user experience of third-generation devices, were released onto the market in the USA in 2015 and subsequently became available in the UK [4]
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