Development of a Questionnaire for Assessing Dependence on Electronic Cigarettes Among a Large Sample of Ex-Smoking E-cigarette Users

Introduction:
This text summarizes a study on the development of a questionnaire for assessing dependence on electronic cigarettes (e-cigs) among a large sample of ex-smoking e-cigarette users. The study aims to compare ratings of dependence on electronic cigarettes with tobacco cigarettes in a sample of ex-smokers who have switched to e-cigs, and to assess the validity of the e-cig dependence index by examining the relationship of the e-cig dependence index with the concentration of nicotine in the liquid being used.

Key Points:

* The study found that current e-cigarette users reported being less dependent on e-cigarettes than they retrospectively reported having been dependent on cigarettes prior to switching.
* E-cig dependence appears to vary by product characteristics and liquid nicotine concentration, and it may increase over time.
* The Penn State Electronic Cigarette Dependence Index was developed, which comprises 10 items, including adapted items from the FTND/HSI, HONC, and items assessing waking at night to use and recent strength of urges to use.
* The index predicted 1-month intent-to-treat CO-verified abstinence in a smoking cessation trial, with those scoring 0-10 at baseline having a 74% quit rate, those scoring 11-14 having a 52% quit rate, and those scoring 15-20 having a 27% quit rate.
* The study found that those who had used e-cigs longer had higher e-cig dependence scores, as did those using more advanced e-cigs that were larger than a cigarette and had a manual button.
* Those using zero nicotine liquid had significantly lower e-cig dependence scores than those using 1-12 mg/ml, who scored significantly lower than those using 13 or greater mg/ml nicotine liquid.
* The study suggests that the items selected for the index are somewhat sensitive to nicotine consumption after controlling for frequency of use.

Main Message:
The study highlights the importance of developing methods of assessing dependence in ways that can facilitate comparison across products, and the need for measures capable of assessing nicotine dependence in other products. The Penn State Electronic Cigarette Dependence Index was developed and validated as a brief and easily adaptable measure of e-cigarette dependence, which can be useful in both research and clinical settings. The study also provides insights into how e-cig dependence varies by product characteristics and liquid nicotine concentration, and how it may increase over time. Overall, the study underscores the importance of understanding and measuring dependence on e-cigarettes as the popularity of these products continues to grow.

Foulds, J., S. Veldheer, J. Yingst, S. Hrabovsky, S. J. Wilson, T. T. Nichols, and T. Eissenberg. “Development of a Questionnaire for Assessing Dependence on Electronic Cigarettes Among a Large Sample of Ex-Smoking E-Cigarette Users.” Nicotine & Tobacco Research 17, no. 2 (February 1, 2015): 186–92. https://doi.org/10.1093/ntr/ntu204.