Cigarette smokers often reject electronic cigarettes, study shows

Not wanting to substitute one addictive product for another was cited as a major reason why U.S. smokers who have never used electronic nicotine delivery systems (ENDS) rejected them as a means to quit cigarettes, according to a study by tobacco researchers from Georgia State University's School of Public Health.

ENDS, battery-powered devices used to smoke or vape, include electronic cigarettes and vaping devices that often contain nicotine, an addictive chemical, in their solution.

Published in Drug and Alcohol Dependence, the study used a 2017-18 sample of about 1,800 U.S. adults from the Tobacco Products and Risk Perceptions Survey data, a national online survey. Seventy percent of current smokers in the study were not current ENDS users who had either never used (40 percent) or discontinued using ENDS while continuing to smoke (more than 30 percent).

The larger segment of smokers in the study who have never used ENDS cited other reasons for rejecting them, including concerns about their safety and skepticism that ENDS could help them quit or cut down on smoking.

According to the study, the smaller but sizable segment of smokers who tried but discontinued ENDS reported the device did not replicate the feel of smoking a traditional cigarette and failed to reduce the craving to smoke.

The researchers reported smokers who were formerly regular users of ENDS indicated greater intentions to use them if a best friend were to offer them one than never or former experimental users.

"For ENDS to achieve their potential for harm reduction, they need to be sufficiently appealing to smokers to initiate and continue using them in complete replacement of smoking cigarettes while not appealing to youth or nonsmokers," said Scott Weaver, lead author of the study and research associate professor in the School of Public Health. "Smokers' increasing concerns about addiction and their safety and experiences of inadequate craving reduction and incomparability to smoking remain major obstacles for ENDS to completely replace and meaningfully reduce the societal harm of cigarette smoking."