Electronic cigarette use: comparing smokers, vapers, and dual users on characteristics and motivational factors

INTRODUCTION: This study examined vaping behaviour, precursors of vaping, and motivational differences between smokers, dual users and vapers. The objectives were to assess a) vaping characteristics and reasons for use, b) differences in motivational factors and behavioural precursors associated with e-cigarette use, and c) socio-demographic and motivational factors associated with electronic cigarette use. METHODS: A cross-sectional survey among 259 vapers, 135 smokers, and 83 dual users was conducted in the Netherlands. The questionnaire, based on the I-Change Model, assessed demographics, smoking and vaping behaviour, quit attempt, attitudes towards e-cigarettes, social influences, self-efficacy about not to vape and intention to quit. RESULTS: Vaping e-cigarettes was mostly started for health reasons. Less than 2% of the vapers had never used conventional cigarettes. Vapers reported most advantages of e-cigarettes whereas smokers were least convinced of them, encountered more modelling of vaping in their social environment and reported higher self-efficacy to control vaping. Older respondents and respondents with low levels of education and low income were more likely to use e-cigarettes instead of conventional cigarettes. CONCLUSIONS: Although vaping was mostly started for health reasons, the use of the product was not strictly limited to (former) smokers. Health communication for non-smokers is needed to stress potential dangers. Both vapers and non-vapers encounter barriers for using e-cigarettes in difficult situations. If e-cigarettes are used as a smoking cessation tool, more information is needed to help users cope with these situations. For future interventions we recommend to take potential motivational differences among low and high income and educated groups into account.