Dual Users Compared to Smokers: Demographics, Dependence, and Biomarkers.

Introduction:
This text is a summary of a research study that aimed to characterize a community sample of established dual users of electronic cigarettes (e-cigarettes) and combustible cigarettes compared to exclusive smokers. The study focused on demographic variables, cigarette dependence, and exposure to carcinogens. The study's key points provide insights into the characteristics and behaviors of dual users and their potential health risks.

Key Points:

* The study recruited 422 participants, including 166 exclusive smokers and 256 dual users, over a 2-year period.
* Dual users were more likely to be white, younger, have more than a high school education, report a psychiatric history, and live with someone who uses e-cigarettes.
* among the dual users, the most common type of device used was a refillable tank, and the most commonly used e-liquid flavors were fruit and menthol.
* Dual users reported vaping a mean of 5.5 days/week and 10.0 times per day, taking a mean of 2.2 puffs per vaping occasion.
* Dual users smoked significantly fewer cigarettes, were less likely to smoke within 30 minutes of waking, had lower FTCD scores, reported higher motivation to quit smoking, and had lower levels of NNaL (a carcinogen) than exclusive smokers.
* There were no differences in expired carbon monoxide or nicotine metabolite levels between dual users and exclusive smokers, suggesting that dual users may compensate for smoking fewer cigarettes by obtaining supplemental nicotine from e-cigarettes.
* The sample size of dual users who smoked fewer than 5 cigarettes/day was small (11.7%), and sensitivity analyses did not change the comparability of the two samples.

Main Message:
The study provides valuable insights into the characteristics and behaviors of dual users of e-cigarettes and combustible cigarettes compared to exclusive smokers. The findings suggest that dual users are more likely to be white, younger, have more than a high school education, report a psychiatric history, and live with someone who uses e-cigarettes. additionally, dual users smoked significantly fewer cigarettes, had lower levels of a tobacco-specific carcinogen, and reported higher motivation to quit smoking than exclusive smokers. however, there were no differences in expired carbon monoxide or nicotine metabolite levels between dual users and exclusive smokers, indicating that dual users may compensate for smoking fewer cigarettes by obtaining supplemental nicotine from e-cigarettes. The study's findings can inform regulatory measures and public health policies related to e-cigarette use and dual use.

Piper ME, Baker TB, Benowitz NL, Kobinsky Kh, Jorenby DE. Dual Users Compared to Smokers: Demographics, Dependence, and Biomarkers. Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco. 2019;21(9):1279-1284. doi:10.1093/ntr/nty231