Evaluation of Dependence and Nicotine Replacement Therapy-Supported Cessation Efforts among Regular Electronic Cigarette Users - Project Summary. Electronic cigarette (ECIG) use has increased in the U.S. since ECIGs were introduced to the market in 2006. While ECIG use among adults was originally most common among current cigarette smokers, in recent years there has been an increase in the prevalence of ECIG use among individuals who have never been established cigarette smokers as well as former cigarette smokers who have transitioned to ECIG use. Little is known about this population of non-smoking ECIG users, including if they experience unique indicators of ECIG dependence. However, most ECIG dependence assessments rely on self-report measures that were developed from those originally designed to measure cigarette smoking dependence. These measures may not capture indicators of dependence that are unique to ECIG use and more relevant to ECIG users who are not current cigarette smokers. Additionally, as ECIG use among non-current smokers has increased, so has the interest in ECIG cessation among this population. Best practices have been developed to support cigarette smoking cessation including the use of combination nicotine replacement therapy (NRT) products, such as the nicotine patch and lozenge. Given that the primary addictive substance in ECIGs is nicotine, NRT has the potential to be an effective tool for ECIG cessation. Yet the ability of NRT to support ECIG cessation, which has been evaluated in only two pilot studies, remains unclear. Moreover, this pilot work relied on user self-reports to measure ECIG abstinence. Indeed, objective methods to verify ECIG use behaviors and abstinence during cessation attempts are urgently needed. One such method may be measuring ECIG liquid weights across days to represent the amount of liquid consumed. Another method may be the measurement of propylene glycol (PG), a primary component of ECIG liquid that has been demonstrated to be detected and quantified in users’ urine. This project aims to examine 1) indicators of dependence that are unique to ECIG use, 2) the impact of NRT on short-term ECIG cessation attempts, and 3) novel methods for verifying ECIG use behaviors and short-term ECIG abstinence. Data from this project will increase understanding of ECIG dependence, including indicators that may be unique to ECIG use relative to cigarette smoking and are not captured in current measures of ECIG dependence. This project will also provide important data on how NRT may support ECIG cessation among non-current smokers as well as an evaluation of several approaches that can be used to verify ECIG use behaviors and abstinence beyond user self-report, both of which are valuable for development of best practices for supporting ECIG cessation. Thus, successful completion of this project will support efforts to prevent negative health outcomes associated with ECIG dependence and use.
