Subjective experiences of the addictive potential of E-cigarettes: results from focus group discussions

Figures & data

Table 1. Definition of themes guiding the deductive analysis based on Bold et al.’s (2018) domains of e-cigarette addiction.

Theme	Description
Quantity and frequency of use	Reports of frequent e-cigarette use, high duration of use, or when excessive use is perceived as a problem.
Tolerance	Reports about tolerance development, e.g. lack of nicotine flash or increase of nicotine dose to feel effect.
Perceived benefits	Reports that vaping helps when feeling down or just puts users in a good mood. Reports of vaping to help with concentration.
Withdrawal symptoms	Description of physiological and psychological withdrawal symptoms, for example, restlessness, irritability, difficulty concentrating, sweating, trembling, or palpitations, when not vaping for a longer period or when using e-cigarettes with lower nicotine doses.
Craving/urge to use	Description of the desire to use e-cigarettes or frequent thoughts about it, e.g. when other people vape nearby, in the morning after getting up, when forgetting the e-cigarette at home, or in situations where e-cigarette use is forbidden. In addition, in the context of habits that one cannot give up, for example, vaping when drinking alcohol.
Use despite harm	Physical Harm: Report of consumption in situations in which physical danger can be assumed. Health risks: Report of continued use despite negative health effects or knowledge of health risks (both physical and psychological). Social risks: Report of continued use despite disapproval or conflict with friends, colleagues or family.
Impaired control	Reports of unsuccessful attempts to stop, reduce, or keep e-cigarette use or nicotine level constant.
Automaticity	Reports of habitual e-cigarette use, e-cigarette use without thinking about it or making a deliberate decision to vape, not realizing the e-cigarette use while vaping.
Preferred over competing rewards	Reports that activities are avoided if vaping is not possible (e.g. going to the cinema, train ride), and other rewards are foregone for e-cigarette use.
Sensory dependence	Reports about enjoying vaping, or the smell, feeling or other aspects of e-cigarette use.

Figure 1. Model of the addictive potential of e-cigarettes (MAPE). Two of the domains (impaired control, preferred over competing rewards) identified by Bold et al. were not found in this study and therefore are not depicted here.

Bold KW, Sussman S, O'Malley SS, Grana R, Foulds J, Fishbein H, Krishnan-Sarin S. 2018. Measuring E-cigarette dependence: initial guidance. Addict Behav. 79:213–218. doi: 10.1016/j.addbeh.2017.11.015.

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Data availability

The data that support the findings of this study are available in German on request from the corresponding author [MA]. The data are not publicly available since they contain information that could compromise the privacy of research participants.