title: A comparison of nicotine dependence among exclusive E-cigarette and cigarette users in the PATH study.
abstract: Electronic cigarettes ("e-cigs") have recently gained in popularity, but their health risks, including dependence potential are unclear. This study analyzed the adult database from the Wave 1 Population Assessment of Tobacco and Health (PATH) Study, a nationally representative survey of tobacco use in the United States, to assess the relative level of dependence among adult, exclusive everyday users of e-cigarettes and cigarettes. Of the total 32,320 observations from the Wave 1 PATH adult database, 3586 (5.9%, weighted) were eligible for our analysis population. Among those who met the eligibility criteria, 156 (4.6%) were exclusive e-cig users, and 3430 (95.4%) were exclusive cigarette smokers. Our results show that e-cig users reported a significantly longer time-to-first-use of the day after waking (measured in minutes) compared to cigarette smokers after adjusting for confounders (adjusted geometric mean [95% confidence limits (CL)]: 29.2 [24.4-34.9] vs. 20.0 [18.7, 21.5]). In addition, cigarette smokers were significantly more likely to consider themselves addicted (Adj. Odds Ratio [95% CL]: 6.9 [4.5-10.7]); have strong cravings (2.9 [1.9-4.2]); find it difficult in the past 12months to refrain from using their product in places where it was prohibited (6.4 [2.9-14.3]); and feel like they really needed to use their product (3.9 [2.4-6.4]). These results are consistent with previous studies, in finding that exclusive daily e-cigarette users are less dependent on their respective product than comparable cigarette smokers.
authors.affiliation: Department of Public Health Sciences, Penn State University College of Medicine, Hershey Medical Center, Hershey, PA 17033-0850, United States; Penn State Tobacco Center of Regulatory Science, Penn State University College of Medicine, Hershey Medical Center, Hershey, PA 17033-0850, United States; Center for Applied Studies in Health Economics, Penn State University College of Medicine, Hershey Medical Center, Hershey, PA 17033-0850, United States. Electronic address: gliu@phs.psu.edu.
authors.forename: Guodong
authors.initials: G
authors.lastname: Liu
authors.affiliation: Department of Public Health Sciences, Penn State University College of Medicine, Hershey Medical Center, Hershey, PA 17033-0850, United States; Penn State Tobacco Center of Regulatory Science, Penn State University College of Medicine, Hershey Medical Center, Hershey, PA 17033-0850, United States.
authors.forename: Emily
authors.initials: E
authors.lastname: Wasserman
authors.affiliation: Department of Public Health Sciences, Penn State University College of Medicine, Hershey Medical Center, Hershey, PA 17033-0850, United States.
authors.forename: Lan
authors.initials: L
authors.lastname: Kong
authors.affiliation: Department of Public Health Sciences, Penn State University College of Medicine, Hershey Medical Center, Hershey, PA 17033-0850, United States; Penn State Tobacco Center of Regulatory Science, Penn State University College of Medicine, Hershey Medical Center, Hershey, PA 17033-0850, United States.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Foulds
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D066300:Electronic Nicotine Delivery Systems / Q000706:statistics & numerical data*; D005260:Female; D006306:Health Surveys; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011795:Surveys and Questionnaires; D062789:Tobacco Products / Q000706:statistics & numerical data*; D014029:Tobacco Use Disorder / Q000453:epidemiology*
keywords: Addiction; Adults; Cigarettes; Dependence; E-cigarettes; Electronic cigarettes; Inhaled nicotine device; Nicotine; Smoking; Tobacco