Nicotine dependence among young adults: Comparing exclusive ENDS users to exclusive cigarette smokers

Purpose: No studies of young adults have compared symptoms of nicotine dependence among exclusive past 30day (P30D) ENDS users versus exclusive P30D cigarette smokers. Methods: Participants at Wave 14 (Fall 2021) of The Texas Adolescent and Tobacco Marketing Surveillance System (TATAMS) (n = 2,341; mean age = 20.95 years old) who reported P30D exclusive ENDS use (n = 212) and P30D exclusive cigarette smoking (n = 46). Symptoms of nicotine dependence were measured with the Hooked On Nicotine Checklist (the 10-item HONC scale). An independent samples t-test compared average HONC scores between groups, and a Pearson (or Fisher's Exact) Chi-Square (X2) test compared the prevalence of symptom(s) between groups. Results: The average HONC score was significantly higher for exclusive P30D ENDS users than exclusive P30D cigarette smokers (3.51 vs. 1.91, p <= 0.001). Compared to exclusive P30D cigarette smokers, a significantly higher proportion of exclusive P30D ENDS users reported having felt addicted (45.28% vs. 15.22%, p <= 0.001), having strong cravings (50.00% vs. 28.26%, p = 0.007), difficulty not using in prohibited places (i.e., school or work) (24.06% vs. 4.35%, p = 0.002), difficulty concentrating (21.23% vs. 6.52%, p = 0.021), and feeling nervous, restless, or anxious (28.77% vs. 10.87%, p = 0.012). Conclusions: Symptoms of nicotine dependence were elevated among young adults who were exclusive P30D users of ENDS relative to exclusive P30D cigarette smokers.

Automated summary

This study compared symptoms of nicotine dependence among young adults who were exclusive past 30-day (P30D) users of electronic nicotine delivery systems (ENDS) versus exclusive P30D cigarette smokers. The results showed that young adults who used ENDS exhibited higher levels of nicotine dependence symptoms compared to cigarette smokers.