Perceived efficacy of e-cigarettes versus nicotine replacement therapies among successful e-cigarette users – a qualitative approach

Nicotine is recognized as an addictive psychoactive drug. Most smokers are bio-behaviorally addicted, and quitting is often accompanied by withdrawal symptoms. Research indicates that nicotine replacement therapy can double quit rates. However, the success rate for quitting remains low. E-cigarettes are battery-powered nicotine delivery devices used to inhale doses of vaporized nicotine without the harmful chemicals present in tobacco products. Anecdotal evidence strongly suggests that electronic cigarettes may be effective in helping smokers quit and prevent relapse, but there have been few published qualitative studies, especially among successful e-cigarette users, which explain why. Qualitative design using focus groups (N=11); 9 males and 2 females. Focus groups were conducted posing open-ended questions relating to the use of e-cigarettes, comparison of effectiveness between NRT's and e-cigarettes, barriers to quitting, and reasons for choosing e-cigarettes over other methods. Results: Five main reasons - themes – emerged that describe users perception of why e-cigs are efficacious in quitting smoking: 1) Bio-behavioral feedback, 2) Social benefits, 3) Hobby elements, 4) Personal identity, 5) Distinction between smoking cessation and nicotine cessation. Subjects reported their experiences with NRT's compared to electronic cigarettes and their perceived efficacy citing negative side effects of NRT's and their inability to prevent relapse. These findings suggest that tobacco control practitioners must pay increased attention to the importance of the behavioral and social components of smoking addiction. By addressing these components in addition to nicotine dependence, electronic cigarettes appear to be helping some users in transitioning from smoking cigarettes and maintaining cigarette abstinence.