title: Perceived efficacy of e-cigarettes versus nicotine replacement therapy among successful e-cigarette users: a qualitative approach.
abstract: BACKGROUND
  Nicotine is widely recognized as an addictive psychoactive drug. Since most smokers are bio-behaviorally addicted, quitting can be very difficult and is often accompanied by withdrawal symptoms. Research indicates that nicotine replacement therapy (NRT) can double quit rates. However, the success rate for quitting remains low. E-cigarettes (electronic cigarettes) are battery-powered nicotine delivery devices used to inhale doses of vaporized nicotine from a handheld device similar in shape to a cigarette without the harmful chemicals present in tobacco products. Anecdotal evidence strongly suggests that e-cigarettes may be effective in helping smokers quit and preventing relapse, but there have been few published qualitative studies, especially among successful e-cigarette users, to support this evidence.
  
  
  METHODS
  Qualitative design using focus groups (N = 11); 9 men and 2 women. Focus groups were conducted by posing open-ended questions relating to the use of e-cigarettes, comparison of effectiveness between NRTs and e-cigarettes, barriers to quitting, and reasons for choosing e-cigarettes over other methods.
  
  
  RESULTS
  Five themes emerged that describe users' perceptions of why e-cigarettes are efficacious in quitting smoking: 1) bio-behavioral feedback, 2) social benefits, 3) hobby elements, 4) personal identity, and 5) distinction between smoking cessation and nicotine cessation. Additionally, subjects reported their experiences with NRTs compared with e-cigarettes, citing negative side effects of NRTs and their ineffectiveness at preventing relapse.
  
  
  CONCLUSIONS
  These findings suggest tobacco control practitioners must pay increased attention to the importance of the behavioral and social components of smoking addiction. By addressing these components in addition to nicotine dependence, e-cigarettes appear to help some tobacco smokers transition to a less harmful replacement tool, thereby maintaining cigarette abstinence.
authors.affiliation: Department of Community Health Sciences, Boston University School of Public Health, 801 Massachusetts Avenue, 3rd Floor, Boston, MA 02118, USA. abarbeau@bu.edu
authors.forename: Amanda M
authors.initials: AM
authors.lastname: Barbeau
authors.forename: Jennifer
authors.initials: J
authors.lastname: Burda
authors.forename: Michael
authors.initials: M
authors.lastname: Siegel
mesh_terms: D000293:Adolescent; D000328:Adult; D001294:Attitude to Health; D001900:Boston; D005260:Female; D017144:Focus Groups; D006801:Humans; D008297:Male; D008875:Middle Aged; D009330:Nebulizers and Vaporizers; D009538:Nicotine / Q000008:administration & dosage*; D036301:Qualitative Research; D055502:Secondary Prevention; D016540:Smoking Cessation; D061485:Tobacco Use Cessation Devices / Q000009:adverse effects; D055815:Young Adult
chemical_list: D009538:Nicotine