Understanding perceived addiction to and addictiveness of electronic cigarettes among electronic cigarette users: a cross-sectional analysis of the International Tobacco Control Smoking and Vaping (ITC 4CV) England Survey.

Introduction:
This text presents the findings of a cross-sectional study examining the perceived addiction to and addictiveness of electronic cigarettes (e-cigarettes) among e-cigarette users in England. The study aimed to identify patterns and correlates of perceived addiction to e-cigarettes and the relative addictiveness of e-cigarettes compared to tobacco cigarettes in dual users and exclusive e-cigarette users.

Key Points:

* The study used data from the International Tobacco Control Project (ITC) Four Country Smoking and Vaping (4CV) Survey in England, 2016.
* The sample consisted of 832 current e-cigarette users who had been vaping for at least 4 months.
* Perceived addiction to e-cigarettes and relative addictiveness were examined using logistic regression, adjusting for age, gender, education, and tobacco cigarette smoking status.
* a sensitivity analysis was performed in exclusive e-cigarette users (non-smokers) using the same models as the main analysis without adjustment for smoking status.
* The study found that 17% of participants reported feeling very addicted to e-cigarettes, while 40% considered e-cigarettes equally or more addictive than tobacco cigarettes.
* all markers of addiction, daily use, and enjoyment were associated with higher perceived addiction, while time to first vape after waking, daily vaping, and perceiving vaping as less satisfying than smoking were associated with relative addictiveness.
* The study suggests that self-reported perceived addiction might serve as an indicator of addiction, and the prevalence of markers of addiction and perceived addiction were comparatively low overall, indicating a limited but relevant addictive potential of e-cigarettes.

Main Message:
The study provides valuable insights into the perceived addiction to and addictiveness of e-cigarettes among e-cigarette users. The findings suggest that positive and negative reinforcement, reflected here by enjoyment and relative satisfaction, might play a role in e-cigarette addiction. While the prevalence of markers of addiction and perceived addiction was comparatively low, the study highlights the need for further research to understand the long-term health risks and harm potential of e-cigarettes, particularly in relation to addiction. The study's results may inform regulatory measures and public health policies regarding e-cigarette use and addiction.

Lohner V, McNeill a, Schneider S, et al. Understanding perceived addiction to and addictiveness of electronic cigarettes among electronic cigarette users: a cross-sectional analysis of the International Tobacco Control Smoking and Vaping (ITC 4CV) England Survey. addiction (abingdon, England). 2023;118(7):1359-1369. doi:10.1111/add.16162