Switching between vaping devices, nicotine concentration, and flavors among people who use e-cigarettes daily: Results from a 12-Month longitudinal study

Abstract

Background: E-cigarettes vary widely in product characteristics (e.g., device type, nicotine concentration, and flavor). Little is known about how people who use e-cigarettes switch between products with different characteristics. We tracked the stability/variability in characteristics of products used by individuals who vaped e-cigarettes daily over one year.

Methods: Of 126 enrolled participants who vaped e-cigarettes daily and did not use other nicotine products, 80 completed 12 monthly study visits. Participants reported device type, nicotine concentration, and flavors used in the past 30 days at each visit. Participants were also asked to bring e-cigarette devices and e-liquids to each visit. Study staff took pictures of products carried by participants and categorized product characteristics.

Results: Over one year, 35.0 % of participants did not change device type, nicotine concentration, or flavor type. However, 35 % of participants changed device type, 31.3 % changed nicotine concentration, and 46.3 % changed flavor at least once. The most common change in device type was switching from open to closed system devices (67.9 %). The rate of switching from low to high nicotine (≤24 vs. > 24 mg/mL) was more common than the reverse (56.6 % vs. 43.4 %). The most common change in flavor was switching between Fruit/Sweet and Hybrid (Fruit/Sweet with a cooling additive, 75.7 % of flavor switching events).

Conclusions: Most study participants switched one product characteristic at least once during a 12-month study period. Users most frequently switched flavors and least frequently switched nicotine concentrations. Future studies should consider the variability of product use patterns among people who use e-cigarettes.

Keywords: E-cigarettes; ENDS; Flavors; Nicotine; Product characteristics; Switching.