Interest in quitting e-cigarette use by device type and smoking history in US adults.

INTRODUCTION Motivations for using electronic nicotine delivery systems (ENDS)
include quitting or reducing cigarette smoking, flavor, and addiction. This study
examines whether the primary reason for continued ENDS usage changes over
time, and its association with device and liquid characteristics.
METHODS Data are from a longitudinal cohort study and include 526 US adults (≥21
years) using ENDS frequently (≥5 days/week) as self-reported, and uploaded
photos of their most used ENDS devices and liquids and self-reported primary
reason for continued ENDS usage in wave 2 (December 2020–April 2021) and
wave 5 (February–April 2023). Device-liquid grouping was defined by device
(disposable/disposable pod/refillable pod/tank, adjustable/no adjustable settings)
and liquid (salt/freebase) characteristics. A device was classified as having
adjustable settings if it allowed users to modify the power, coil, or airflow. Data
were analyzed using multivariable logistic regressions and McNemar tests.
RESULTS From wave 2 to 5, the primary reason for continued ENDS usage significantly
changed, with more participants reporting addiction (29.2% vs 34.6%, p<0.001);
and significantly more participants used disposable devices (salt, no adjustable
settings) (7.9% vs 25.2%, p<0.001). Compared to those using tanks (freebase,
adjustable settings), participants using devices with nicotine salt liquids were more
likely to report addiction (AOR>2; 95% CI: 1.12–8.19); and participants using
disposable devices (salt, no adjustable settings) were less likely to report quitting/
reducing smoking as the primary ENDS use reason after controlling for smoking
status and sociodemographic characteristics (AOR<0.6; 95% CI: 0.14–0.995).
CONCLUSIONS Over a 2.5-year period, the proportion of participants continuing
to use ENDS at least 5 days/week because of addiction grew, and participants’
motivations varied by device-liquid grouping. Restrictions on nicotine salts may
disproportionately impact those using ENDS because of addiction; and regulations
targeting tanks with freebase liquids may disproportionately impact those using
ENDS for smoking cessation/reduction.

Palmer aM, Rojewski aM, Carpenter MJ, et al. Interest in quitting e-cigarette use by device type and smoking history in US adults. Tobacco control. Published online January 17, 2023. doi:10.1136/tc-2022-057710