Background
Methods
Qualitative phase
Quantitative phase
“Cigarette” referred to “real” combustible cigarette.
“E-cigarette” referred to a product that heats a liquid producing an aerosol that can be inhaled.
“Tobacco vaporizer” or “vaporizer” referred to a product that heats tobacco producing an aerosol that can be inhaled.
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Current or past utilization of a tobacco vaporizer and intention to use it, brand and model (open-ended questions).
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Reasons for using one, duration and frequency of utilization, number of refills and puffs per day, number of puffs per refill (note: Brand 1 is designed to produce a maximum of 14 puffs per stick, and at the time of data collection only tobacco and menthol flavors were available for Brand 1 refill sticks [2]), monthly expenditure on vaporizers and refills.
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Assessment of the taste, perceived feelings, satisfaction and perceived advantages and disadvantages.
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Perceived risk and comparison of risk with combustible cigarettes.
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Current or past utilization of nicotine replacement medications, other medication for stopping smoking or e-cigarettes. Intention to stop smoking or to reduce smoking, previous quit attempts, tobacco dependence (on a scale from 0 to 100) [31], confidence in ability to stop smoking
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Age, gender, country of residence
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Presence of a tobacco related disease, cannabis use and hazardous alcohol consumption (AUDIT-C) [32].
Statistical analysis
Ethics and informed consent
Results
Participation
Qualitative phase
Quantitative phase
All users | |
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Number of respondents | 102 |
Gender (males %) | 47.0 |
Age (years)a | 41 (30, 51) |
Hazardous alcohol consumption: | |
AUDIT-C Score ≥ 4 among males (%) | 75.6 |
AUDIT-C Score ≥ 3 among females (%) | 76.1 |
Ever used cannabis in past 12 months: | |
- Ever (%) | 14.0 |
Does your spouse/fiancé smoke | |
- Yes (%) | 43.0 |
In general, would you say your health is: | |
- Very good to excellent (%) | 49.5 |
Do you currently use a nicotine medication? (patch, chewing-gum, tablet, inhaler, nasal spray)? | |
- Yes, every day (%) | 5.1 |
- Yes, occasionally (%) | 2.0 |
Do you currently use an e-cigarette? | |
- Yes, every day (%) | 26.0 |
- Yes, occasionally (%) | 9.0 |
Use only vaporizer (no consumption of cigarettes, e-cigarettes or nicotine medication) (%) | 26.5 |
All users | |
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Number of respondents | 102 |
Tobacco use: (in current users of the tobacco vaporizer, n = 98) | |
- Daily smoker (%) | 34.8 |
- Occasional smoker (%) | 21.3 |
- Former smoker (%) | 43.8 |
- Never smoker (%) | 0.0 |
Currently, do you use oral or snuff tobacco: | |
- Yes, (occasionally or every day) (%) | 8.2 |
Before using a tobacco vaporizer, were you a smoker (or user of snuff/oral tobacco): | |
- Daily smoker (%) | 92.0 |
- Occasional smoker (%) | 4.0 |
- Former smoker (%) | 4.0 |
- Never smoked (%) | 0.0 |
Number of cigarettes per day before using the tobacco vaporizera | 20.0 (10.5, 21.5) |
The first time you used nicotine, which product did you use: | |
- A cigarette, cigar or pipe (%) | 98.0 |
- An electronic cigarette (%) | 2.0 |
Age when began to smoke everyday (years)a | 16.5 (15.75, 18.0) |
Tobacco vaporizer utilization: | |
- Every day (%) | 88.2 |
- Occasionally (%) | 7.9 |
- Former user (%) | 3.9 |
Do you intend to use a tobacco vaporizer in the future? | |
(Intend to use/certain to use one) (%) | 90.3 |
Among former users: duration of utilization (days)a | 5.0 (3.0, 5.0) |
Current smokers (n = 58): | |
- Number of cigarettes per daya | 10.0 (3.75, 16.25) |
- How long after waking do you smoke the first cigarette of the day (minutes)a | 30.0 (10.0, 50.0) |
- Heaviness of smoking index (HSI) (%): | |
0–1: | 31.6 |
2–4: | 68.4 |
5–6: | 0.0 |
- Cigarette dependency (self-rating scale of 0 to 100)a | 80.0 (43.75, 96.0) |
- Decided to stop smoking (now or in the next 30 days) (%) | 9.0 |
- Intend to stop in the next six months (%) | 7.1 |
- Sure to succeed stopping smoking if you try (very sure) (%) | 14.5 |
- Currently trying to stop smoking (%) | 28.6 |
- Currently trying to reduce cigarette consumption (%) | 80.0 |
- Duration of most recent quit attempt (days)a | 14 (3.0, 90.0) |
- Duration of longest quit attempt (days)a | 135.0 (21.0, 365.0) |
Former smokers (n = 40): | |
- When did you stop smoking (days ago)a | 67 (36.0, 438.0) |
- Before stopping, number of cigarettes per day on averagea | 20.0 (10.5, 23.0) |
Tobacco vaporizer utilization
Current users | |
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Number of current users | 98 |
Duration of utilization (days)a | 269.0 (59.0, 469.0) |
Utilization: | |
Every day (%) | 91.8 |
Occasionally (%) | 8.2 |
Before using your vaporizer, how many cigarettes did you smoke per day, on average (current daily or occasional vaporizer users who were smokers when they started to use the vaporizer, n = 94)a | 20.0 (10.0, 20.0) |
Number of cigarettes per day now (among all current vaporizer users and current smokers)a | 8.0 (3.0, 15.0) |
Number of cigarettes per day now (among every daily vaporizer users and current smokers)a | 7.5 (3.25, 13.75) |
Number of refill sticks per daya | 10.0 (5.75, 10.0) |
Total number of cigarettes plus vaporizer refills per day (in current smokers)a | 16.5 (12.0, 21.0) |
First utilization of the day of vaporizer, how many minutes after waking (minutes)a | 30.0 (15.0, 60.0) |
Number of puffs per day on the vaporizera | 150.0 (50.0, 210.0) |
Number of puffs per sticka | 12.0 (10.0, 14.0) |
Duration of one recharge of the battery (hours)a | 24.0 (12.0, 48.0) |
Number of sticks per one recharge of the batterya | 20.0 (20.0, 20.0) |
Monthly expenditure for vaporizer and sticks (Euros)a | 110.0 (59.0, 161.0) |
Intention to use vaporizer for more than one year (%) | 58.9 |
Utilization of vaporizer and cigarettes on the same day: | |
- Ever (%) | 59.2 |
- For more than one month (%) | 15.4 |
Reason for using both vaporizer and cigarettes on the same day: | |
- To reduce cigarette consumption (%) | 57.6 |
- In places where smoking is prohibited (%) | 19.7 |
- Because I like to use both (%) | 28.8 |
Utilization of the vaporizer instead of a smoking cessation medication: | |
- Ever (%) | 48.1 |
- For more than one month (%) | 28.4 |
Reasons for use
Quite true to totally true (%) | All users |
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Number of respondents | 102 |
To replace cigarettes | 94.1 (89.5–98.7) |
Less toxic than smoking tobacco | 89.2 (83.2–95.2) |
To stop smoking or to avoid starting smoking again | 72.3 (63.6–81.0) |
To reduce my tobacco consumption but without the intention of stopping smoking | 71.3 (62.5–80.1) |
Because I don’t want to smell of tobacco smoke | 70.7 (61.8–79.6) |
To cope with tobacco withdrawal symptoms | 69.6 (60.7–78.5) |
Because I like using it | 65.0 (55.7–74.3) |
To not disturb others with tobacco smoke | 57.4 (47.8–67.0) |
To reduce my tobacco consumption in preparation for stopping smoking | 56.4 (46.7–66.1) |
Because I’m dependent on my vaporizer | 53.5 (43.7–63.3) |
To manage urges to smoke | 49.0 (39.3–58.7) |
Because all the other smoking cessation methods I tried have failed | 41.6 (32.0–51.2) |
Because, despite my efforts, I’m not able to stop using my vaporizer | 37.4 (27.9–46.9) |
To manage stress | 35.3 (26.1–44.5) |
To avoid the need to go outside to smoke | 26.0 (17.4–34.6) |
In situations or places where smoking is prohibited | 23.0 (14.8–31.2) |
Cheaper than tobacco | 14.0 (7.2–20.8) |
The vaporizer helps me control my weight | 4.0 (0.2–7.8) |
I cannot smoke because of a disease | 2.0 (0.0–4.7) |
Perceived effects
All users | |
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Number of respondents | 102 |
How would you describe the ‘hit’ or ‘throat hit’ provoked by your vaporizer: | |
- Strong to very strong (%) | 14.7 (7.9–21.5) |
- Medium (%) | 30.4 (21.5–39.3) |
- Weak to very weak (%) | 54.9 (45.2–64.6) |
Would you describe the vaporizer taste as: | |
- Good to very good (%) | 59.4 (49.8–69.0) |
- Neutral (%) | 34.7 (25.4–44.0) |
- Bad to very bad (%) | 5.9 (1.3–10.5) |
Is the taste of your vaporizer similar of the taste of a cigarette? | |
- Similar (%) | 1.0 (0.0–2.9) |
- Near to very near (%) | 31.0 (22.0–40.0) |
- Different to very different (%) | 68.0 (58.9–77.1) |
Would you say the taste of your vaporizer is an advantage or a disadvantage for stopping smoking? | |
- Advantage to big advantage (%) | 60.8 (51.3–70.3) |
- Disadvantage to big disadvantage (%) | 10.8 (4.8–16.8) |
Could the taste of your vaporizer make you want to smoke a cigarette? | |
- A lot (%) | 2.9 (0.0–6.2) |
- Low to moderate (%) | 28.4 (19.6–37.2) |
- Not at all (%) | 68.6 (59.6–77.6) |
Does your vaporizer irritate your throat? | |
- Strongly (%) | 9.0 (3.4–14.6) |
- Not at all (%) | 65.0 (55.7–74.3) |
How would you estimate the general risk to health from the vaporizer, compared to cigarettes? | |
- 100 times less dangerous (%) | 20.8 (12.9–28.7) |
- 10 times less dangerous (%) | 49.5 (39.7–59.3) |
- 2 times less dangerous (%) | 21.8 (13.9–29.8) |
- Probably the same risk as cigarettes (%) | 6.9 (2.0–11.8) |
- Probably more dangerous than cigarettes (%) | 1.0 (0.0–2.9) |
Former smokers (n = 40): | |
Did your vaporizer help you to stop smoking? | |
- Yes (a little to absolutely) (% of former smokers) | 67.5 (53.0–82.0) |
Current smokers (n = 58): | |
Does (did) your vaporizer help you to reduce your cigarettes consumption? | |
- Yes (a little to absolutely) (% of current smokers) | 84.5 (75.2–93.8) |
Satisfaction
All users | |
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Number of respondents | 102 |
Are you satisfied with your vaporizer (scale of 0 to 10)a | 8.0 (7.0, 9.0) |
I like the feeling I get when I inhale the vapor from my vaporizer | |
- Somewhat agree to totally agree (%) | 66.7 (57.4–76.0) |
Have you ever recommended other people to use a vaporizer: | |
- Yes, one person (%) | 24.5 (16.2–32.8) |
- Yes, several people (%) | 55.9 (46.3–65.5) |
Do you think that other people began to use a vaporizer because of your recommendation or your example? | |
- Yes, one person (%) | 25.7 (17.2–34.2) |
- Yes, several people (%) | 21.8 (13.8–29.8) |
I’m afraid I may start smoking again when I stop using my vaporizer | |
- Somewhat agree to totally agree (% of former smokers) | 64.7 (56.3–74.1) |
Perceived advantages - Somewhat agree to totally agree (%): | |
It’s easy not to smoke when I use my vaporizer | 82.0 (74.5–89.5) |
It does not produce a bad smell | 73.0 (64.3–81.7) |
I cough less | 68.0 (58.9–77.1) |
I have better breath | 66.0 (56.7–75.3) |
I get less short of breath after a physical effort | 60.7 (51.1–70.3) |
Improved senses of taste and smell | 43.0 (33.3–52.7) |
Perceived disadvantages: - Somewhat agree to totally agree (%) | |
I’m afraid of becoming dependent on my vaporizer | 57.6 (47.9–67.3) |
The vapor should be more concentrated | 24.0 (15.6–32.4) |
My vaporizer should act more quickly (faster relief of urge to smoke) | 20.2 (12.3–28.1) |
It should be easier to draw/inhale on the vaporizer | 19.0 (11.3–26.7) |
Vaporizer should deliver more nicotine | 10.0 (4.1–15.9) |