Impact of E-Cigarette Sampling on Cigarette Dependence and Reinforcement Value

Summary of Study

Bottom LineThis analysis suggests that providing an e-cigarette to current cigarette smokers is likely to reduce cigarette dependence, especially if the e-cigarette delivers sufficient nicotine and is used frequently.

E-cigarettes have risen in prevalence in recent years, and most public health experts agree they deliver fewer toxicants than combustible tobacco products such as cigarettes. Most experts agree that the public health impact of e-cigarettes is likely to depend on whether they increase or decrease the prevalence of combustible cigarette use. Among current smokers, some research suggests that e-cigarettes, especially those that deliver nicotine effectively, can aid in smoking cessation and reduce rates of smoking even among those who do not quit. 

However, some researchers have argued that e-cigarettes can delay quitting and reduce quitting success by diverting smokers away from using more effective stop smoking treatments. Thus, it is important to understand how use of e-cigarettes by current smokers impacts dependence on combustible cigarettes.

In this study, individuals assigned to receive an e-cigarette had significantly lower mean smoking dependence scores at the end of sampling and the end of the follow-up period compared to those in the control group. Both frequency of e-cigarette use as well as nicotine concentration of the e-cigarette given to smokers were significant predictors of changes in the mean smoking dependence score. E-cigarette sampling also significantly reduced smoking demand. 

These data are encouraging in that they suggest that current smokers who try e-cigarettes may experience a reduction in dependence on combustible cigarettes. Not surprisingly, using the e-cigarette more often is likely to result in greater reductions in nicotine dependence. Choosing an e-cigarette that delivers sufficient nicotine may be important in determining whether that product effectively substitutes for cigarettes. The changes in cigarette dependence observed here were sustained past the sampling period.

If e-cigarettes were suddenly unavailable, individuals who have switched from cigarettes to e-cigarettes may switch back because cigarettes still hold high reinforcement value in this context.

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