Comparison of the characteristics of long-term users of electronic cigarettes versus nicotine replacement therapy

Background: Electronic cigarettes (EC) and nicotine replacement therapy (NRT) are non-tobacco nicotine delivery devices widely used as partial or complete long-term substitutes for smoking. Yet, little is known about the characteristics of long-term users, including their views of these devices. Methods: Participants were recruited from four naturally occurring groups of long-term (≥6 months) users of either EC or NRT who had stopped or continued to smoke (N=36 per group, total N=144). Participants completed a questionnaire assessing socio-demographic and smoking characteristics, nicotine withdrawal symptoms, smoker identity and appraisal of products they were using. Findings: EC use was associated with stronger smoker identity (Wald-X2(1)=3.9,p=0.048) and product endorsement (Wald-X2(1)=4.6,p=0.024), irrespective of smoking status. Among ex-smokers, EC users reported less severe mood symptoms (Wald-X2(1)=6.1,p=0.014) and cravings (Wald-X2(1)=8.5,p=0.003), higher perceived helpfulness of the product (Wald-X2(1)=4.8,p=0.028) and lower intentions to stop using the product than NRT users (Wald-X2(1)=17.6,p<0.001). Discussion: Compared with NRT users, EC users have a stronger smoker identity and like their products more. EC are perceived as more helpful and effective which may maintain continued nicotine consumption among long-term users who have stopped smoking.