title: Adverse Effects of Electronic Cigarette Use: A Concept Mapping Approach.
abstract: BACKGROUND
  Electronic cigarette (ECIG) use has grown rapidly in popularity within a short period of time. As ECIG products continue to evolve and more individuals begin using ECIGs, it is important to understand the potential adverse effects that are associated with ECIG use. The purpose of this study was to examine and describe the acute adverse effects associated with ECIG use.
  
  
  METHODS
  This study used an integrated, mixed-method participatory approach called concept mapping (CM). Experienced ECIG users (n = 85) provided statements that answered the focus prompt "A specific negative or unpleasant effect (ie, physical or psychological) that I have experienced either during or immediately after using an electronic cigarette device is…" in an online program. Participants sorted these statements into piles of common themes and rated each statement. Using multidimensional scaling and hierarchical cluster analysis, a concept map of the adverse effects statements was created.
  
  
  RESULTS
  Participants generated 79 statements that completed the focus prompt and were retained by researchers. Analysis generated a map containing five clusters that characterized perceived adverse effects of ECIG use: Stigma, Worry/Guilt, Addiction Signs, Physical Effects, and Device/Vapor Problems.
  
  
  CONCLUSIONS
  ECIG use is associated with adverse effects that should be monitored as ECIGs continue to grow in popularity. If ECIGs are to be regulated, policies should be created that minimize the likelihood of user identified adverse effects.
  
  
  CONCLUSIONS
  This article provides a list of adverse effects reported by experienced ECIG users. This article organizes these effects into a conceptual model that may be useful for better understanding the adverse outcomes associated with ECIG use. These identified adverse effects may be useful for health professionals and policy makers. Health professionals should be aware of potential negative health effects that may be associated with ECIG use and policy makers could design ECIG regulations that minimize the risk of the adverse effects reported by ECIG users in this study.
authors.affiliation: Department of Psychology and Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA; eksoule@vcu.edu.
authors.forename: Eric K
authors.initials: EK
authors.lastname: Soule
authors.affiliation: Department of African American Studies, Department of Psychology and Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA;
authors.forename: Aashir
authors.initials: A
authors.lastname: Nasim
authors.affiliation: Department of Research, Concept Systems, Incorporated, Ithaca, NY.
authors.forename: Scott
authors.initials: S
authors.lastname: Rosas
mesh_terms: D000328:Adult; D001007:Anxiety; D003371:Cough; D066300:Electronic Nicotine Delivery Systems / Q000009:adverse effects / Q000523:psychology / Q000706:statistics & numerical data; D005260:Female; D006167:Guilt; D006801:Humans; D008297:Male; D008962:Models, Theoretical; D057545:Social Stigma; D055815:Young Adult