How Addictive Are E-Vapor Products?

Vaper’s Vortex

May 4, 2015

“E-cigarettes may be as or less addictive than NRTs – which themselves are not very addictive.”

How addictive are e-vapor products? More importantly, since the majority of e-vapers are current or former smokers, are they more or less addictive than tobacco cigarettes? Are they addictive at all? Some researchers even question whether nicotine itself, in the absence of the chemicals added by Big Tobacco to cigarettes, is addictive.

In the absence of much else to say, public health and politicians are focusing the majority of their rhetoric on the addictiveness of nicotine. Which of course leads to the addictiveness of e-vapor products which contain nicotine. Which of course leads to the increased use of e-vapor by teens. Which they predictably insist is synonymous with addiction to nicotine.

Now, public health and politicians are not concerned about the presence, or lack of, credible science behind their claims. But for the rest of us, what do we know?

Jonathan Foulds, Professor of Public Health Sciences and Psychiatry at Penn State College of Medicine conducted an online survey to answer the question of how addictive are e-vapor products compared to tobacco cigarettes. To answer that question, online respondents were asked to complete the Penn State Cigarette Dependence Index and the Penn State Electronic Cigarette Dependence Index. 3,500 current e-cigarette users, all ex-cigarette smokers, completed both indices. The results were released in December of last year in Nicotine & Tobacco Research.

  • Higher ecig nicotine content was associated with higher dependence.
  • Use of second generation e-vapor products were associated with higher dependence. Presumably because these products deliver nicotine more effectively than Big Tobacco cigalikes.
  • The longer users had used e-vapor, the more addicted they appeared to be.

No surprises there. But Foulds then went on to say:

“However, people with all the characteristics of a more dependent e-cig user still had a lower e-cig dependence score than their cigarette dependence score. We think this is because they’re getting less nicotine from the e-cigs than they were getting from cigarettes.”

Foulds concluded that not only are e-vapors less addictive than tobacco cigarettes, but improvements in the ability of e-vapor products to more effectively deliver nicotine might result in helping more users quit smoking.

The same month that Foulds’ study was released, a second study was released by Jean Francois Etter, Professor of Public Health at the University of Geneva. Etter’s survey went beyond Foulds’ and compared three groups:

  1. Daily nicotine e-cig users with daily non-nicotine e-cig users.
  2. Former smokers using e-cigs daily with former smokers using nicotine replacement therapy (NRT) products daily.
  3. Daily e-cig and tobacco cigarette users (dual users) with daily smokers who did not use e-cigs.

The results:

  • Users of nicotine e-cigs were only slightly more dependent (addicted) than users of non-nicotine e-cigs.
  • Former smokers using e-cigs for more than three months (“long term users”) were less dependent on e-cigarettes than “long term users” of NRT products.

That last finding led Etter to conclude that e-cigarettes may be as or less addictive than NRTs – which themselves are not very addictive [emphasis mine].

Last but not least, a third web based survey, possibly the most widely referenced in scientific circles, was conducted by Maciej L. Goniewicz, PhD et al. in March of 2013. These researchers concluded:

“Although half of respondents said they are addicted to e-cigarettes, only one-third thought e-cigarettes were as addictive as conventional cigarettes and two-thirds believed they are either not as addictive or not addictive at all. This finding is in line with previous studies.”

It is interesting to note that at the time this study was published by the National Institutes of Health, Goniewicz was a postdoctoral fellow at the Center for Tobacco Control Research and Education at the University of California San Francisco. Many will recognize UCSF as the stomping ground of none other than Stanton Glantz.

I’m betting ‘ol Stan was not pleased about highly respected research that contradicts virtually every word of alarmist, unsupported propaganda that he calls “science”.

Dr. Goniewicz joined the Roswell Park Cancer Institute in 2013 and has authored over 40 scientific papers on topics related to tobacco control, biomarkers, and nicotine-containing products.

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Dave Coggin has a Master’s Degree in business and spent 35 years in corporate America. He is a co-founder and partner in DIYELS. He has spent the last five years actively researching and following the evolution of the e-cigarette industry. He is a strong proponent of e-cigarettes as the most promising option currently known for tobacco harm reduction. He may be contacted directly at .

The opinions presented here are exclusively those of the author. Vaper’s Vortex is offered as a service to our customers and followers. Anyone considering e-cigarettes as an alternative to tobacco cigarettes should seek qualified advice from a medical professional.

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