a comparison of product dependence among cigarette only, ENDS only, and dual users: Findings from Wave 3 (2015-2016) of the PaTh study.

Introduction:
This text summarizes a study that compares self-reported product dependence among individuals who use cigarettes only, electronic nicotine delivery systems (ENDS) only, and both cigarettes and ENDS (dual users). The study uses data from Wave 3 (2015-2016) of the PaTh Study and assesses tobacco dependence using the Wisconsin Inventory of Smoking Dependence Motives (WISDM) items. The key points and main message of the study are provided below.

Key Points:

* The study included 5,538 cigarette only users, 399 ENDS only users, and 108 dual users.
* There was no difference in cigarette dependence between dual and cigarette only users, but dual users' ENDS dependence was lower than that for ENDS only users.
* ENDS appeared to produce less dependence than cigarettes among dual users.
* The study controlled for age, sex, race, education, household income, cannabis use in ENDS, and ENDS flavor.
* The PaTh Study population weights were used to adjust for the complex study design, including oversampling and non-response.
* The dependence instruments are first used to measure non-electronic tobacco products (referred to as 'cigarettes') and then used to measure ENDS dependence.
* Two main outcomes were used: cigarette dependence (CD) score and ENDS dependence (ED) score, which are the averages of 11 WISDM items asked to measure non-electronic and electronic tobacco product dependence, respectively.

Main Message:
The main message of the study is that dual users' ENDS dependence is lower than that for ENDS only users, indicating that ENDS produce less dependence than cigarettes among dual users. This finding is crucial for regulatory agencies to consider when developing policies around ENDS, especially in the context of the increasing popularity of ENDS and dual use of cigarettes and ENDS.

Kaplan B, alrumaih F, Breland a, Eissenberg T, Cohen JE. a comparison of product dependence among cigarette only, ENDS only, and dual users: Findings from Wave 3 (2015-2016) of the PaTh study. Drug and alcohol dependence. 2020;217:108347. doi:10.1016/j.drugalcdep.2020.108347