The authors write: “Cigarette smoking often results in nicotine dependence. With use of electronic cigarettes as an alternative source of nicotine, it is important to assess dependence associated with e-cigarette use. This study assesses dependence among current and former adult e-cigarette users on cigarettes and e-cigarettes, compared with dependence on cigarettes.”
The pair state there is broad agreement that vaping poses less risk than cigarette smoking, and has the potential for harm reduction, “but some have expressed concern about their potential to cause or perpetuate nicotine dependence.”
They say that although there have been studies suggesting that vaping is associated with less dependence, “the studies were based on unrepresentative samples and used measures that had not been validated for comparing degree of dependence between e-cigarettes and conventional cigarettes.”
Sembower and Shiffman set out to correct this with their new paper.
- In within-subject comparisons among current established users of both cigarettes and ecigarettes (dual users), dependence was significantly lower on e-cigarettes compared to cigarettes
- Dependence on e-cigarettes was also lower than dependence on smoking among daily users of each product, and among non-daily users of each
- A between-subjects analysis among individuals who either smoked cigarettes or used e- cigarettes, but not both, showed the same pattern: dependence was lower among e- cigarette users
- Scores for e-cigarette dependence were lower than those for cigarette dependence both for daily and non-daily users
- Among former established users of both cigarettes and e-cigarettes who stopped both in the past year (i.e., former dual users), within-person comparison showed that residual dependence was significantly lower on e-cigarettes
- A similar pattern was seen in between-person comparison of former e-cigarette users and former smokers who were not former dual users
They found the highest level dependence was reported by current vapers who had quit smoking during the past year. They rated their dependence on vaping higher “than that reported among e-cigarette users who were still smoking.”
However, they point out, this dependence on vaping was still far less than the cigarette dependence of current smokers.
They concluded that this observation, “is consistent with the idea that smokers might transition to exclusive e- cigarette use by transferring their dependence to e-cigarettes instead. It could also be due to the fact that stopping smoking completely and transitioning to e-cigarettes is most likely when e-cigarettes are used more regularly and in greater amounts, which might be associated with greater dependence.”
Many anecdotal accounts from the Planet of the Vapes forum have shown that vapers believe they are far less addicted to vaping than they were to cigarette smoking.
- “Dependence on E-Cigarettes and Cigarettes in a Cross-Sectional Study of US Adults” by Sembower and Shiffman – [link]