LAUSR

BACKGROUND Greater nicotine delivery is associated with higher nicotine concentrations in Electronic Nicotine Delivery System (ENDS) liquids. However, there is a current debate as to whether this leads to increased dependence and mitigates ENDS public health potential. METHODS Self-reported dependence among users of myblu ENDS containing different nicotine concentrations was examined with data from a multi-wave cross-sectional survey of US young adults and adults. Questions examined responses related to dependence measures and participants' most often used myblu ENDS nicotine concentration (low: 0%, 1%, 1.2%; medium: 2%, 2.4% and 2.5%; or high: 3.6% and 4%). RESULTS A global General Linear Model using nicotine concentration, age, and days myblu was used in the past 30 revealed a significant difference in PROMIS scores among nicotine concentration groups (F = 4.07, p = 0.02). However, pairwise comparisons to examine which specific groups differed significantly from others showed no significant differences. Logistic regression demonstrated that strong past 30-day cravings to use myblu among participants using high or medium nicotine concentrations were not significantly different from those using a low concentration (ORs 0.66 [0.42, 1.03], p=0.07 and 0.95 [0.49, 1.82], p=0.98, respectively). Time to daily first use for high or medium nicotine concentration users was not significantly different from those using a low concentration (ORs 0.89 [0.70, 1.14], p=0.35 and 0.84 [0.57, 1.25], p=0.40, respectively). CONCLUSIONS Use of myblu ENDS with different nicotine concentrations is not associated with differing levels of dependence. Our findings contradict the notion that high ENDS e-liquid nicotine levels generate increased dependence.