The Novice User’s Experience of the Titan 510 Electronic Cigarette: a Mixed Methods Approach

1. The Novice User’s Experience of the Titan 510 Electronic Cigarette: a Mixed Methods Approach Victoria Lawson, Sharon Cahill & Lynne Dawkins School of Psychology, University of East London, London, E15 4LZ, UK E-mail: l.e.dawkins@uel.ac.uk Background Quantitative Results Findings Electronic cigarettes (EC) are tobacco free substitutes which mimic the look, feel and action of smoking whilst delivering nicotine via inhaled vapour. Regular users strongly endorse its effectiveness: in two recent internet based surveys of electronic cigarette users, more than 70% claimed that the EC had helped them to quit smoking (Dawkins et al., 2013; Etter & Bullen, 2011) yet no studies have explored the novice user’s experience. This mixed methods study aims to qualitatively explore the naïve users’ experience of the EC from first exposure to its use over one-week, and to quantitatively explore effects on craving, cigarette consumption and expired carbon monoxide (CO). Compared with placebo, the nicotine e-cigarette reduced desire to smoke and tobacco withdrawal symptoms, and improved time-based but not event-based PM. There was a moderate, marginally significant negative correlation between PM performance during abstinence and nicotine dependence. Quantitative results: Level of nicotine dependence (FTND), smoking years, baseline CO level, motivation to quit and confidence in quitting all varied greatly among the five participants. CO level and average cigarette consumption was reduced, craving frequency and strength showed little change and average mood became slightly more positive. Aims The present mixed methods study intends to generate functional conclusions relative to the naïve user’s experience. It aims to assess the naïve users’ experience of using the EC from the initial ‘out-of-the-box’ experience, to its use over a one-week period, and to quantitatively explore whether expired carbon monoxide (CO), number of cigarettes smoked, nicotine withdrawal symptoms and craving change from baseline to active study week. Quotes from focus group: “I wouldn’t be able to do it [completely abstain from smoking] without it” “I guess I get the habit of holding the cigarette and smoking and the motion and all this so I think I will stick to it” “I think it’s quite nice though ‘cos you can smell the smoke from them and you’re taking, blowing it out and you’re like, it’s alright. Gets you through it, it’s having that social side still” Method A sequential mixed methods design is utilized with a qualitative emphasis. Five participants took part and (3 female, mean age: 29 years) completed daily smoking and craving diaries at baseline and during a one-week quit attempt. Participants were video-recoded i) at first-exposure whilst assembling a new EC starter kit, and ii) at the end of a one week quit attempt as part of a focus group (data were thematically analysed). The Titan 510 Electronic Cigarettewas supplied by Totally Wicked E-Liquids with one weeks supply of 18mg nicotine cartridges (50; with a choice of tobacco or menthol flavour). A Carbon monoxide (CO) breathalyser (BedfontSmokerlyser) was used to measure expired CO. A Baseline assessment form comprised 8 questions pertaining to smoking habits, motivation to quit and previous quit attempts. The Fagerstrom Test of Nicotine Dependence (FTND; Heatherton, Kozlowski, Frecker & Fagerstrom, 1991) is a six-item scale assessing smoking dependence Scores range from 0 (low dependence) to 10 (high dependence). A One week smoking and craving diary was completed at baseline and again during the active study week. This assessed number of cigarettes smoked a day (mean taken over the 7 days), details of any other form of nicotine ingestion, craving frequency (on a % scale showing % of the day spent craving or thinking about smoking a cigarette; with options of 0%, 10%, 25%, 50%, 75% and 100%) and craving strength (1 no craving to 10 severe craving), and overall mood for the day (ranging from -5 to +5). Conclusions Experience of the vaping was heavily influenced by practical problems associated with using the EC reflecting lack of familiarity with the device. Negative comparisons were made to tobacco smoking but favourable comparisons to NRT with behavioural and social aspects of EC use strongly endorsed. Number of cigarettes smoked and CO levels declined significantly from baseline to active study week whilst craving remained unchanged. These findings suggest that EC use can reduce tobacco consumption but highlight the need for clearer in-box guides and better information and support for new EC users. References: Heatherton, T., Kozlowski, L., Frecker, R., Fagerstrom, K., (1991) The Fagerstrom Test for Nicotine Dependence: a revision of the Fagrstrom Tolerance Questionnaire. British Journal of Addiction 89 (9) 1119-1127 Etter, J-F., & Bullen, C. (2011). Electronic cigarette: users profile, utilization, satisfaction and perceived efficacy. Addiction, 106, 2017-2028. Dawkins, L., Turner, J., Roberts, A. & Soar, K. (2013). ‘Vaping’ profiles and preferences: an online survey of electronic cigarette users. Addiction, doi: 10.1111/add.12150 www.uel.ac.uk/psychology