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Levels of Dependence: E-cigs, Cigarettes, and Nicotine Gum


As a smoker, I became used to hearing criticism of my choices, from menthol cigarettes being worse for you than regular cigarettes to debates about what type of filter my cigarette had. With all of the things I was told I didn't once hear anything about actual studies that were completed regarding the "safety" of cigarettes. This bothered me for a couple reasons. One, I didn't appreciate being judged, let alone by someone smoking alongside me, and two, I didn't learn anything.

When I switched to vaping, I began to hear even more criticism about my choices, and I'm sure many vape users have had the same experience. I faced false claims about e-juice having even more chemicals in it than traditional cigarettes, and that using a vape wouldn't help me quit smoking, but rather deepen my dependence on nicotine.  I had begun vaping based on the decision that vaping would be an improvement as a lesser harm, but the criticism struck a chord. Instead of getting mad, I got into the research. Was it true my method for smoking cessation was only going to increase my addiction to nicotine? I wanted to find out what research had to say.

A Study of Dependence

Jean-Francois Etter and Thomas Eissenberg completed a research study comparing dependence levels across e-cigs, tobacco cigarettes, and nicotine gum. The research was conducted through self-reporting, where participants were asked to respond to questions based on their own opinions and experiences. These reports were cross-sectional and conducted using internet and mail surveys utilizing the six-item Fagerstrom Test for Nicotine Dependence and the Nicotine Dependence Syndrome Scale. The cigarette dependence scale was also used, and adapted across the various items of interest.


When participants were self-reporting, they were asked to compare their current dependence on e-cigs or nicotine gum, to their past dependence on traditional tobacco cigarettes. Many reported that they were using vaping as a means to avoid returning to smoking cigarettes.This research also included dual users, or individuals who alternate smoking traditional cigarettes and vaping. Data showed that once those individuals switched to dual-use, their cigarette intake decreased up to fifty percent. These participants also rated their dependence on e-cigs as lower than tobacco cigarettes.

Etter and Eissenberg's study found that the dependence ratings were slightly higher in vape users who used devices with nicotine than those who didn't. Results showed that vapers were less dependent than those using nicotine gum, when looking at data collected from former smokers who were using either vaping or nicotine gum for more than three months. While some of the individuals surveyed were dependent on e-cigs that contained nicotine, participants believed them to be less addictive than traditional tobacco cigarettes. Based on this research, it was determined that e-cigs may cause less dependence than nicotine gum, which is typically not considered very addictive.

A Look Ahead

Limitations of this study were based primarily on the lack of a dependence scale for e-cigs and nicotine gum, as well as the fact that it relied on participants to make judgments on their own without researcher supervision. Still, it provides a useful look into how people are actually using vaping as it relates to nicotine replacement therapies. The study provides a strong basis for further research and helps give vape users peace of mind when using their device for smoking cessation.