Eric K Soule1, Joseph G L Lee2, Kathleen L Egan3, Kendall M Bode4, Abigail C Desrosiers5, Mignonne C Guy6, Alison Breland7, Pebbles Fagan8. 1. Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, 1000 East 1st Street, Mail Stop 529, Greenville, NC 27858 USA; Center for the Study of Tobacco Products, Virginia Commonwealth University, 100 W Franklin St., Suite 200, Richmond, VA 23220 USA. Electronic address: soulee18@ecu.edu. 2. Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, 1000 East 1st Street, Mail Stop 529, Greenville, NC 27858 USA; Cancer Prevention and Control, UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC USA. Electronic address: leejose14@ecu.edu. 3. Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, 1000 East 1st Street, Mail Stop 529, Greenville, NC 27858 USA. Electronic address: eganka18@ecu.edu. 4. Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, 1000 East 1st Street, Mail Stop 529, Greenville, NC 27858 USA; Cancer Prevention and Control, UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC USA. Electronic address: bodek16@ecualumni.ecu.edu. 5. Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, 1000 East 1st Street, Mail Stop 529, Greenville, NC 27858 USA; Cancer Prevention and Control, UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC USA. Electronic address: desrosiersa17@students.ecu.edu. 6. Center for the Study of Tobacco Products, Virginia Commonwealth University, 100 W Franklin St., Suite 200, Richmond, VA 23220 USA; Department of African American Studies, College of Humanities and Sciences, Virginia Commonwealth University, PO Box 842509, Richmond, VA 23284 USA. Electronic address: mguy@vcu.edu. 7. Center for the Study of Tobacco Products, Virginia Commonwealth University, 100 W Franklin St., Suite 200, Richmond, VA 23220 USA; Department of Psychology, College of Humanities and Sciences, Virginia Commonwealth University, Richmond, VA 100 W Franklin St., Suite 200, Richmond, VA 23220 USA. Electronic address: abbrelan@vcu.edu. 8. Center for the Study of Tobacco Products, Virginia Commonwealth University, 100 W Franklin St., Suite 200, Richmond, VA 23220 USA; Department of Health Behavior and Health Education, Fay W. Boozman College of Public Health, Center for the Study of Tobacco, University of Arkansas for Medical Sciences, 4301 West Markham, # 820, Little Rock, AR 72205 USA. Electronic address: pfagan@uams.edu.
Abstract
BACKGROUND: Limited research has examined indicators of electronic cigarette (ECIG) dependence. Researchers have adapted ECIG dependence measures from cigarette smoking dependence measures, but few have examined unique aspects of ECIG dependence. This study used concept mapping, a mixed-methods approach to examine ECIG user-identified indicators of ECIG dependence. METHODS: In 2019, we recruited current ECIG users (n = 75; 52.9 % women; mean age = 33.2, SD = 9.9) from 25 states to complete an online study. Participants completed a brief survey and brainstormed statements (n = 216) completing the prompt: "Something specific that makes me think I am addicted to using my electronic cigarette/vaping device is…" After duplicate content was removed, participants sorted the final list of 93 statements by content similarity and rated statements on how true statements were for them (1 - Definitely NOT true to 7 - Definitely true). Multidimensional scaling analysis identified ECIG dependence thematic clusters. RESULTS: We identified ten themes: Craving, Negative Affect, Vaping as a Necessity, Therapeutic Effects, Preparedness, Attachment to Device, Impact on Daily Activity, Physical Withdrawal Symptoms, Monetary Cost, and Shame or Embarrassment. Those who had higher ECIG dependence scores and those who reported more frequent ECIG use had higher mean cluster ratings than those with lower ECIG dependence scores and who reported less frequent ECIG use. (ps<.05). CONCLUSIONS: ECIG dependence has similarities to cigarette smoking dependence, but dependence indicators appear to be unique to ECIG use. Health professionals and the public should be aware of ECIG dependence risk and indicators.
BACKGROUND: Limited research has examined indicators of electronic cigarette (ECIG) dependence. Researchers have adapted ECIG dependence measures from cigarette smoking dependence measures, but few have examined unique aspects of ECIG dependence. This study used concept mapping, a mixed-methods approach to examine ECIG user-identified indicators of ECIG dependence. METHODS: In 2019, we recruited current ECIG users (n = 75; 52.9 % women; mean age = 33.2, SD = 9.9) from 25 states to complete an online study. Participants completed a brief survey and brainstormed statements (n = 216) completing the prompt: "Something specific that makes me think I am addicted to using my electronic cigarette/vaping device is…" After duplicate content was removed, participants sorted the final list of 93 statements by content similarity and rated statements on how true statements were for them (1 - Definitely NOT true to 7 - Definitely true). Multidimensional scaling analysis identified ECIG dependence thematic clusters. RESULTS: We identified ten themes: Craving, Negative Affect, Vaping as a Necessity, Therapeutic Effects, Preparedness, Attachment to Device, Impact on Daily Activity, Physical Withdrawal Symptoms, Monetary Cost, and Shame or Embarrassment. Those who had higher ECIG dependence scores and those who reported more frequent ECIG use had higher mean cluster ratings than those with lower ECIG dependence scores and who reported less frequent ECIG use. (ps<.05). CONCLUSIONS: ECIG dependence has similarities to cigarette smoking dependence, but dependence indicators appear to be unique to ECIG use. Health professionals and the public should be aware of ECIG dependence risk and indicators.
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