E-Cigarette Versus Nicotine Inhaler: Comparing the Perceptions and Experiences of Inhaled Nicotine Devices
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Novel nicotine delivery products, such as electronic cigarettes (e-cigarettes), have dramatically grown in popularity despite limited data on safety and benefit. In contrast, the similar U.S. Food and Drug Administration (FDA)-approved nicotine inhaler is rarely utilized by smokers. Understanding this paradox could be helpful to determine the potential for e-cigarettes as an alternative to tobacco smoking.
To compare the e-cigarette with the nicotine inhaler in terms of perceived benefits, harms, appeal, and role in assisting with smoking cessation.
A cross-over trial was conducted from 2012 to 2013
Forty-one current smokers age 18 and older used the e-cigarette and nicotine inhaler each for 3 days, in random order, with a washout period in between. Thirty-eight participants provided data on product use, perceptions, and experiences.
The Modified Cigarette Evaluation Questionnaire (mCEQ) measured satisfaction, reward, and aversion. Subjects were also asked about each product’s helpfulness, similarity to cigarettes, acceptability, image, and effectiveness in quitting smoking. Cigarette use was also recorded during the product-use periods.
The e-cigarette had a higher total satisfaction score (13.9 vs. 6.8 [p < 0.001]; range for responses 3–21) and higher reward score (15.8 vs. 8.7 [p < 0.001]; range for responses 5–35) than the inhaler. The e-cigarette received higher ratings for helpfulness, acceptability, and “coolness.” More subjects would use the e-cigarette to make a quit attempt (76 %) than the inhaler (24 %) (p < 0.001). Eighteen percent (7/38) of subjects abstained from smoking during the 3-day periods using the e-cigarette vs. 10 % (4/38) using the inhaler (p = 0.18).
The e-cigarette was more acceptable, provided more satisfaction, and had higher perceived benefit than the inhaler during this trial. E-cigarettes have the potential to be important nicotine delivery products owing to their high acceptance and perceived benefit, but more data are needed to evaluate their actual efficacy and safety. Providers should be aware of these issues, as patients will increasingly inquire about them.
- Steinberg, MB, Akincigil, A, Delnevo, CD, Crystal, S, Carson, JL (2006) Gender and age disparities for tobacco dependence treatment: Results of the 2001–2002 National Ambulatory Medical Care Survey. Am J Prev Med 30: pp. 405-412 CrossRef
- Fiore, MC, Jaén, CR, Baker, TB (2008) Treating Tobacco Use and Dependence: 2008 Update. Clinical Practice Guideline. U.S. Department of Health and Human Services. Public Health Service, Rockville
- Steinberg MB, Evans RM, Hughes JR, Leone FT, Lipsky M. Treatment of Tobacco Dependence; AMA Therapeutic Insights; 2011. Available at http://www.ama-assn.org/ama/pub/education-careers/continuing-medical-education/cme-credit-offerings/therapeutic-insights/treatment-tobacco-dependence.page (accessed 25 April 2014).
- Regan, AK, Promoff, G, Dube, SR, Arrazola, R (2013) Electronic nicotine delivery systems: adult use and awareness of the 'e-cigarette' in the USA. Tob Control 22: pp. 19-23 CrossRef
- King, BA, Alam, S, Promoff, G, Arrazola, R, Dube, SR (2013) Awareness and ever-use of electronic cigarettes among U.S. Adults, 2010–2011. Nicotine Tob Res 15: pp. 1623-1627 CrossRef
- Goniewicz ML, Knysak J, Gawron M, et al. Levels of selected carcinogens and toxicants in vapour from electronic cigarettes. Tob Control 2013; [Epub ahead of print].
- Smith, D (2011) Health care consumers use and trust of health information sources. J Commun Healthc 4: pp. 200-210 CrossRef
- Pepper JK, McRee AL, Gilkey MB. Healthcare providers’ beliefs and attitudes about electronic cigarettes and preventative counseling for adolescent patients. J Adolesc Health. 2013; [Epub ahead of print], doi: 10.1016/j.jadohealth.2013.10.001.
- Etter, JF, Bullen, C (2011) Electronic cigarette: users profile, utilization, satisfaction and perceived efficacy. Addiction 106: pp. 2017-2028 CrossRef
- Siegel, MB, Tanwar, KL, Wood, KS (2011) Electronic cigarettes as a smoking-cessation: tool results from an online survey. Am J Prev Med 40: pp. 472-475 CrossRef
- Foulds, J, Veldheer, S, Berg, A (2011) Electronic cigarettes (e-cigs): views of aficionados and clinical/public health perspectives. Int J Clin Pract 65: pp. 1037-1042 CrossRef
- Polosa R, Morjaria JB, Caponnetto P, et al. Effectiveness and tolerability of electronic cigarette in real-life: a 24-month prospective observational study. Int Emerg Med. 2013; [Epub ahead of print].
- Caponnetto, P, Campagna, D, Cibella, F, Morjaria, JB, Caruso, M, Russo, C, Polosa, R (2013) EffiCiency and Safety of an eLectronic cigAreTte (ECLAT) as tobacco cigarettes substitute: a prospective 12-month randomized control design study. PLoS One 8: pp. e66317 CrossRef
- Etter, JF, Bullen, C (2014) A longitudinal study of electronic cigarette users. Addict Behav 39: pp. 491-494 CrossRef
- Bullen, C, Howe, C, Laugesen, M (2013) Electronic cigarettes for smoking cessation: a randomized controlled trial. Lancet 382: pp. 1629-1637 CrossRef
- Blu Cigs website, 2013. Disposable eCig Features, http://www.blucigs.com/disposables (accessed 25 April 2014).
- Wells Fargo Securities, 2013. Tobacco—Nielsen C-Store Data Including E-Cigs. Equity Research.
- Nicotrol Inhaler Website; 2014; https://www1.pfizerpro.com/hcp/nicotrol/nicotrol-Inhaler (accessed 25 April 2014).
- Cappelleri, JC, Bushmakin, AG, Baker, CL, Merikle, E, Olufade, AO, Gilbert, DG (2007) Confirmatory factor analyses and reliability of the modified cigarette evaluation questionnaire. Addict Behav 32: pp. 912-923 CrossRef
- Bullen, C, McRobbie, H, Thornley, S, Glover, M, Lin, R, Laugesen, M (2010) Effect of an electronic nicotine delivery device (e cigarette) on desire to smoke and withdrawal, user preferences and nicotine delivery: randomised cross-over trial. Tob Control 2: pp. 98-103 CrossRef
- Choi, K, Forster, J (2013) Characteristics associated with awareness, perceptions, and use of electronic nicotine delivery systems among young US Midwestern adults. Am J Public Health 103: pp. 556-561 CrossRef
- Cobb NK, Brookover J, Cobb CO. Forensic analysis of online marketing for electronic nicotine delivery systems. Tob Control 2013; [Epub ahead of print].
- Li, J, Bullen, C, Newcombe, R, Walker, N, Walton, D (2013) The use and acceptability of electronic cigarettes among New Zealand smokers. N Z Med J 126: pp. 48-57
- Nides, MA, Leischow, SJ, Bhatter, M, Simmons, M (2014) Nicotine blood levels and short-term smoking reduction with an electronic nicotine delivery system. Am J Health Behav 38: pp. 265-274 CrossRef
- Polosa, R, Caponnetto, P, Morjaria, JB, Papale, G, Campagna, D, Russo, C (2011) Effect of an electronic nicotine delivery device (e-Cigarette) on smoking reduction and cessation: a prospective 6-month pilot study. B.M.C. Public Health 11: pp. 786
- Dawkins, L, Corcoran, O (2014) Acute electronic cigarette use: nicotine delivery and subjective effects in regular users. Psychopharmacology 231: pp. 401-407 CrossRef
- E-Cigarette Versus Nicotine Inhaler: Comparing the Perceptions and Experiences of Inhaled Nicotine Devices
Journal of General Internal Medicine
Volume 29, Issue 11 , pp 1444-1450
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- 1. Rutgers-Robert Wood Johnson Medical School, Division of General Internal Medicine, 125 Paterson Street, Suite 2300, New Brunswick, NJ, 08903, USA
- 2. Rutgers-School of Public Health, Department of Health Education and Behavioral Science, 335 George Street, Suite 2100, New Brunswick, NJ, 08903, USA
- 3. Rutgers-Cancer Institute of New Jersey, Population Science Section, 195 Little Albany Street, New Brunswick, NJ, 08901-1914, USA
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