Are e-cigarettes extra addictive than tobacco?


All of us are conversant in the scene: a bunch of youngsters absentmindedly puffing away at mango-flavoured vapers. However are these stylish and vibrant devices really extra addictive than old-school most cancers sticks?

Vaping has exploded in recognition, with over 3 million grownup vapers at the moment within the UK alone (Motion on Smoking and Well being, 2022). E-cigarettes stay controversial, many individuals use them as a cessation assist whereas scientists fear about their position in rising the danger of smoking amongst youth. We all know that e-cigarettes don’t embody many dangerous chemical compounds that cigarettes embody (Collier, 2017), but the long-term impacts of e-cigarettes are unknown (Marquez et al., 2021). Within the USA, no e-cigarette product has been authorized by FDA as a smoking cessation system. Equally, within the UK, e‑cigarettes should not licensed as medicines however are regulated by the Tobacco and Associated Merchandise Laws (2016). The Nationwide Institute for Well being and Care Excellence (NICE) recommends offering e-cigarettes as an possibility for people who smoke who wish to quit smoking. However, extra analysis is required to find out the protection and effectiveness of e-cigarettes as a smoking cessation assist.

An necessary subject is whether or not e-cigarettes trigger dependancy identical to lethal tobacco. Earlier analysis means that the danger of dependancy, which is often measured by craving or instant e-cigarette use after waking, is decrease in e-cigarette customers in comparison with people who smoke (Liu et al., 2017; Robust et al., 2017). Nonetheless, there are many unknowns relating to the connection between e-cigarettes and dependence. On this new cross-sectional examine, Lohner and colleagues analysed the outcomes of a survey of 832 adults who use e-cigarettes in England to grasp perceptions of e-cigarette dependancy. Their examine explores to what extent e-cigarette customers expertise dependence, and the way this compares to tobacco.

Little research has been conducted to determine the safety and effectiveness of e-cigarettes to aid smoking cessation.

Little analysis has been performed to find out the protection and effectiveness of e-cigarettes to help smoking cessation.


The researchers performed a UK-based cross-sectional examine. In complete, 832 e-cigarette customers in England participated within the survey and self-reported their perceived dependancy to e-cigarettes and perceived addictiveness compared to tobacco cigarettes. The examine explored the connections between perceived dependancy and indicators of dependancy, together with the time it takes to vape for the primary time within the morning, the urge to vape, and nicotine energy, in addition to vaping traits equivalent to frequency and pleasure. The authors adjusted their evaluation for sociodemographic traits, equivalent to age, gender, training and tobacco cigarette smoking standing, and performed sensitivity analyses to manage for confounding elements and bias.


Of all contributors, 17% reported feeling very hooked on e-cigarettes, whereas 35% thought-about e-cigarettes equally addictive as tobacco cigarettes, and just under 6% felt e-cigarettes have been extra addictive than tobacco cigarettes. Members have been predominantly younger in age (28% have been 18-24; 27% have been 25-39), male (64%), and reasonably educated.

The examine confirmed that a number of elements linked to nicotine dependancy additionally associated to feeling very hooked on e-cigarettes. These included vaping proper after waking up, getting robust urges to vape, and utilizing high-nicotine e-liquid. Research contributors who vaped inside 5 minutes of waking have been extra prone to report feeling very addicted in comparison with those that waited over an hour earlier than vaping. Equally, these reporting robust urges to vape had larger odds of feeling very addicted relative to reasonable urges. Moreover, liquid nicotine ranges had a task in dependancy too as individuals utilizing very high-nicotine e-liquid (>15mg/ml) had larger odds of feeling very addicted in comparison with these utilizing low or no nicotine. By way of vaping patterns, utilizing e-cigarettes day-after-day, and getting excessive enjoyment from vaping have been additionally discovered to be related to feeling very addicted.

When perceived addictiveness relative to smoking tobacco, the usage of e-cigarettes inside 5 minutes of waking and each day vaping have been related to the next probability of viewing e-cigarettes as equally or extra addictive in comparison with cigarettes. However most indicators of dependancy weren’t actually tied to considering e-cigarettes are extra addictive than smoking. The one exceptions have been vaping proper after waking up and vaping each day, which associated considerably to perceiving e-cigarettes as very addictive.

Total, this examine discovered that e-cigarettes appear to have some addictive potential, however most customers don’t take into account them as addictive as tobacco cigarettes. Most e-cigarette customers on this examine thought-about themselves not addicted or solely considerably hooked on e-cigarettes and greater than half thought-about e-cigarettes to be much less addictive than tobacco cigarettes.

Markers of nicotine addiction were associated with feeling highly addicted to vaping, but most users considered e-cigarettes less addictive than tobacco.

Markers of nicotine dependancy have been related to feeling extremely hooked on vaping, however most customers thought-about e-cigarettes much less addictive than tobacco.


The examine reveals that whereas some e-cigarette customers present indicators of dependence, the general prevalence of perceived dependancy and markers of dependancy is decrease. It seems that e-cigarettes could be addictive, though maybe to not the identical extent as tobacco cigarettes. Nonetheless, there’s nonetheless a danger of dependence for some customers. It might be helpful to maintain observe of nicotine consumption so as to spot those that are growing an dependancy. The examine additionally reveals that markers of dependancy to e-cigarettes and the perceived dependancy have been constant.

The causal link between e-cigarettes and addiction is muddied by previous or current tobacco addiction.

The causal hyperlink between e-cigarettes and dependancy is muddied by earlier or present tobacco dependancy.

Strengths and limitations

This examine has a comparatively massive pattern dimension and makes use of validated strategies. Nonetheless, it has a cross-sectional design, and can’t set up a cause-and-effect relationship or analyse behaviour over a time period. Maybe a extra necessary limitation is that each one the contributors have been present or former cigarette people who smoke, and solely 165 used e-cigarettes completely. Therefore, it isn’t doable to determine whether or not e-cigarette use created addictiveness that was not already there due to cigarette smoking. Much like many different research on this space, the examine depends on self-reporting, and there’s a danger of misreporting. Aside from these, the contributors have been all adults and the addictiveness of e-cigarettes amongst younger individuals and youngsters is perhaps very completely different as earlier proof means that younger individuals who vape is perhaps extra prone to turn into people who smoke in comparison with those that don’t devour e-cigarettes (Barrington-Trimmis, 2016).

The addictiveness and safety of e-cigarettes need to be further explored with longitudinal studies due to the limitations of cross-sectional research.

The addictiveness and security of e-cigarettes have to be additional explored with longitudinal research.

Implications for observe

This examine offers additional proof for offering e-cigarettes as a cessation assist for grownup people who smoke as many customers understand e-cigarettes as much less addictive than smoking. Since tobacco smoking is extra dangerous than e-cigarettes, the small danger of growing dependence for a subset of e-cigarette customers discovered on this examine appears negligible. Monitoring markers of dependence like time to first use, nicotine ranges, and pleasure might assist establish problematic use.

Subsequently, clinicians ought to monitor and assess patterns of e-cigarette use and nicotine dependancy in sufferers, particularly in people exhibiting indicators of heavy e-cigarette use, robust urges to vape, and early morning vaping. These elements can sign a excessive degree of dependancy and the necessity for help. Moreover, the examine reveals that an necessary variety of e-cigarette customers (just under 6%) understand e-cigarettes as equally or extra addictive than tobacco cigarettes. This notion might affect their attitudes towards quitting or switching from smoking to vaping. Thus, discussing the perceived addictiveness of e-cigarettes with cigarette people who smoke is perhaps necessary in defining the fitting cessation help for people.

Extra analysis is required to completely perceive the elements contributing to e-cigarette dependancy. This may occasionally contain investigating the position of various e-liquid nicotine ranges, patterns of use, and psychological elements in addition to evaluating dependancy in individuals who have solely used e-cigarettes to tobacco people who smoke who’ve by no means used e-cigarettes in longitudinal research.

Clinicians can monitor nicotine levels and dependence on e-cigarettes and help to prevent misuse.

Clinicians can monitor nicotine ranges and dependence on e-cigarettes and assist to stop misuse.

Assertion of pursuits

The creator doesn’t have any battle of curiosity. The views expressed on this weblog belong to the creator and never NICE.


Major paper

Lohner, V., McNeill, A., Schneider, S., Vollstädt‐Klein, S., Andreas, M., Szafran, D., Grundinger, N., Demjén, T., Fernandez, E., Przewozniak, Ok., Tountas, Y., Trofor, A., Zatonski, W., Willemsen, M. C., Vardavas, C., Fong, G. T., & Mons, U. (2023). Understanding perceived dependancy to and addictiveness of digital cigarettes amongst digital cigarette customers: A cross‐sectional evaluation of the Worldwide Tobacco Management Smoking and Vaping (ITC 4CV) England Survey. Habit, 118(7), 1359–1369.

Different references

Barrington-Trimis JL, Urman R, Berhane Ok, et al. (2016) E-Cigarettes and Future Cigarette Use. Pediatrics. 2016, 138(1).

Collier, R. (2017). E-cigs have decrease ranges of dangerous toxins. 2017.

Liu G, Wasserman E, Kong L, Foulds J. (2017) A comparability of nicotine dependence amongst unique E-cigarette and cigarette customers within the PATH examine. Prev Med. 2017 104 86–91.

Marques, P., Piqueras, L. & Sanz, MJ. (2021) An up to date overview of e-cigarette impression on human well being. Respir Res 2021, 22:151.

Robust DR, Pearson J, Ehlke S, et al. (2017) Indicators of dependence for various kinds of tobacco product customers: descriptive findings from wave 1 (2013–2014) of the inhabitants evaluation of tobacco and well being (PATH) examine. Drug Alcohol Rely. 2017 178 257–66.

Motion on Smoking and Well being (2022). Use of e-cigarettes amongst adults in Nice Britain.

Centre for Illness Management and Prevention (2023) About Digital Cigarettes (E-Cigarettes)

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