UB researchers shed light on perception of danger, satisfaction levels of e-cigarette users

Daily users of e-cigarettes see them as about as satisfying or even more satisfying, and less harmful, than cigarettes, according to the results of a small study from the University at Buffalo.

The study of 105 U.S. Army Reserve and National Guard soldiers and their partners found that those study participants who vape daily reported e-cigarettes as "at least as satisfying" as cigarettes, and that 58 percent said vaping was "much more" satisfying.

Researchers also reported that the perception of danger from e-cigarettes decreased as frequency of use increased. The paper was published online first in the journal Preventive Medicine Reports.

"The results argue that satisfaction, perceived harm or danger and product type seem to all work together to promote use or avoidance," said Lynn Kozlowski, the paper's lead author and a professor of community health and health behavior in UB's School of Public Health and Health Professions.

"The mistaken belief that e-cigarettes are more harmful than cigarettes can influence some smokers to not use e-cigs. If the type of product they use is less satisfying, this also can influence likelihood of use," Kozlowski, PhD, added.

Kozlowski's co-authors, both from UB, are Gregory Homish, PhD, associate professor and associate chair of community health and health behavior, and D. Lynn Homish, project director for Operation: SAFETY (Soldiers and Families Excelling Through the Years), a longitudinal research study examining the health and well-being of more than 400 U.S. Army Reserve and National Guard soldiers and their partners.

A subset of the Operation: SAFETY sample size was used for this study, which was funded by the National Institute of Drug Abuse.

In their paper, the researchers note that the findings regarding e-cigarette satisfaction are important because of policies that have been implemented based on the belief that e-cigarettes are fundamentally lacking in satisfaction compared to cigarettes.

The concern that vaping acts as a "gateway" to cigarettes is more credible if vaping is less satisfying than smoking. For vaping products that are much more satisfying than cigarettes and also perceived as less dangerous than cigarettes, it is less likely that users would want to switch to cigarettes in the future, the researchers point out.

"Many people believe that vaping could not be as satisfying as cigarettes, and this lack of satisfaction could encourage switching to the more satisfying product. But our findings indicate that that the non-cigalike vaping products can be very satisfying," Kozlowski said.

The first-generation vaping products that came to market are often called 'cigalikes' — they're electronic cigarettes designed to look and feel like traditional cigarettes. "There is growing evidence that the cigalike products are less effective at delivering nicotine than the newer types of vaping products," Kozlowski said.

The newer devices, which are generally larger, are sometimes referred to as non-cigalikes.

While the sample size is small, the study's results do show something important about the role e-cigarettes can play in harm reduction, says Kozlowski.

"Those who try to exaggerate fears of vaping products should consider their role in keeping smokers smoking," he said. "Telling people only that no product is 'safe' is an irresponsible message."

Instead, Kozlowski said, public health experts need to continue stressing the well-documented dangers of cigarettes and what is likely to be true about differential risks.

"Those smokers who have tried only cig-alike products should know that they may be able to find a more satisfying substitute for smoking in other vaping products," he adds. "The focus should be giving up smoking completely first. After that, we would also encourage giving up vaping, provided it doesn't cause a return to smoking."