Introduction: Little is known about the effects of long-term e-cigarette use, particularly the risks of relapse to cigarette smoking or increased dependence.
Methods: In a 2012-2014 baseline online e-cigarette survey, 1,863 respondents consented to participate in future research. A follow-up online survey was conducted in 2017-2018 to assess changes in e-cigarette use behaviors and e-cigarette-related dependence. For both surveys, exclusive e-cigarette use was defined as only using e-cigarettes in the past 7 days, and poly use was defined as using both e-cigarettes and other tobacco or nicotine products in the past 7 days. The Penn State Electronic Cigarette Dependence Index (PSECDI) score was calculated for each study subject and was used to evaluate e-cigarette dependence. Paired t-tests or Pearson correlation coefficients were used to examine changes in e-cigarette use behaviors or PSECDI scores between baseline and follow-up. Baseline and follow-up survey data were analyzed in January 2019.
Results: A total of 494 subjects provided complete data on both surveys. At baseline, 402 subjects (81.4%) were exclusive e-cigarette users, and 71 subjects (14.4%) were poly users. Among baseline exclusive e-cigarette users, the majority (88.3%) continued using e-cigarettes exclusively, but 37 users (9.2%) became poly users and 1 returned to cigarette smoking at follow-up. Among baseline poly users, 60.6% became exclusive e-cigarette users at follow-up. The mean PSECDI score remained similar over time (8.4 at baseline vs 8.3 at follow-up).
Conclusions: Findings suggest that the risk of relapse to cigarette smoking is low, and e-cigarette-related dependence remains stable in long-term e-cigarette users.
Copyright © 2019 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
Changes in Flavor Preference in a Cohort of Long-term Electronic Cigarette Users.Ann Am Thorac Soc. 2020 Jan 24. doi: 10.1513/AnnalsATS.201906-472OC. Online ahead of print. Ann Am Thorac Soc. 2020. PMID: 31978316
Dependence symptoms and cessation intentions among US adult daily cigarette, cigar, and e-cigarette users, 2012-2013.BMC Public Health. 2016 Aug 18;16(1):814. doi: 10.1186/s12889-016-3510-2. BMC Public Health. 2016. PMID: 27538489 Free PMC article.
Changes in Use Patterns OVER ONE YEAR Among Smokers and Dual Users of Combustible and electronic cigarettes.Nicotine Tob Res. 2019 May 6:ntz065. doi: 10.1093/ntr/ntz065. Online ahead of print. Nicotine Tob Res. 2019. PMID: 31058284
Ethnic Differences in Patterns of Cigarette and E-Cigarette Use Over Time Among Adolescents.J Adolesc Health. 2019 Sep;65(3):359-365. doi: 10.1016/j.jadohealth.2019.04.002. Epub 2019 Jun 24. J Adolesc Health. 2019. PMID: 31248804
Association Between Initial Use of e-Cigarettes and Subsequent Cigarette Smoking Among Adolescents and Young Adults: A Systematic Review and Meta-analysis.Version 2. JAMA Pediatr. 2017 Aug 1;171(8):788-797. doi: 10.1001/jamapediatrics.2017.1488. JAMA Pediatr. 2017. PMID: 28654986 Free PMC article. Review.