Electronic Cigarette Dependence: User and Device Characteristic Predictors

Understanding the dependence potential of electronic cigarettes (ECIGs) is critical to informing prevention and regulatory efforts. Extant work on ECIG dependence is limited, in part due to the vast number of products that differ on their ability to deliver nicotine. Further, existing research is based largely on former/current cigarette smokers, and thus confounds dependence on nicotine via ECIGs versus cigarettes. This study evaluated ECIG device/liquid characteristics and use behaviors as predictors of ECIG dependence in a sample of experienced ECIG users who never smoked cigarettes. Participants completed an online survey that assessed ECIG device/liquid features, use behavior, and ECIG dependence. Additionally, participants uploaded a picture of their personal ECIG product, which was compared to their survey responses for accuracy. Accounting for demographic variables, longer durations of ECIG use and a greater number of use days/week were associated with higher dependence scores. Notably, few ECIG characteristics or device types predicted dependence level after accounting for demographics and use behavior. Comparisons between participants’ self-reports and pictures revealed that agreement was excellent for features of refillable and disposable, good for adjustable power, fair for nicotine formulation, and moderate for device type. Results demonstrate that ECIG device/liquid features are not salient predictors of dependence in never-smoking ECIG users. Future research should include a larger and more diverse sample. Additionally, future work may benefit from a more precise measure of nicotine delivery, as well as verification of ECIG characteristics by requiring participants to provide a picture of their product.