E-Cigarette Design Preference and Smoking Cessation: A U.S. Population Study

Abstract

Introduction: Electronic cigarette (e-cigarette) designs may be described as "closed" or "open." Closed systems are disposable or reloadable with prefilled cartridges (cigalikes). Open systems feature a prominent chamber (tank), refillable with e-liquid. This study examined user design preference and its association with smoking cessation.

Methods: A probability sample of current e-cigarette users (n=923) among adult ever smokers (n=6,560) in the U.S. was surveyed online between February 28 and March 31, 2014, and analyzed in September 2014. Photos of e-cigarette devices were presented alongside survey questions to facilitate respondents' understanding of the questions.

Results: Most e-cigarette users were exclusive users of one design: 51.4% used only closed systems and 41.1% used only open systems, with 7.4% using both. Former smokers were more likely to use open systems than current smokers (53.8% vs 35.2%, p=0.002). Current smokers who attempted to quit in the last 12 months were more likely to use open systems than those who did not (41.4% vs 27.7%, p=0.029). Open system users were more likely than closed system users to use e-cigarettes daily (50.2% vs 22.9%, p<0.0001). Open system users were less likely to report their devices resembled (3.1% vs 73.0%, p<0.0001) or tasted like (29.1% vs 53.3%, p<0.0001) a cigarette but were more likely to report that their devices satisfied cravings than closed system users (82.8% vs 67.2%, p=0.001).

Conclusions: Preference of e-cigarette design is associated with smoking cessation. A device's ability to deliver more nicotine and its flexibility in use might contribute to users' success in quitting smoking.