LAUSR

BACKGROUND AND AIMS It has been proposed that many smokers switch to vaping because their nicotine addiction makes this their only viable route out of smoking. We compared indicators of prior and current cigarette smoking dependence and of relapse in former smokers who were daily users of nicotine vaping products ('vapers') or who were not vaping at the time of survey ('non-vapers'). DESIGN Cross sectional survey-based comparison between vaping and non-vaping former smokers, including a weighted logistic regression of vaping status onto predictor variables, adjusting for covariates specified below. SETTING US, Canada, Australia, England PARTICIPANTS: 1070 people aged 18+ years from the 2016 ITC 4 Country Smoking and Vaping Wave 1 Survey who reported having ever been daily smokers but who stopped less than two years ago and who were currently vapers or non-vapers. MEASUREMENTS Dependent variable was current vaping status. Predictor variables were self-reported: 1) smoking within five minutes of waking and usual daily cigarette consumption, both assessed retrospectively; 2) current perceived addiction to smoking, urges to smoke and confidence in staying quit. Covariates: country, sample sources, sex, age group, ethnicity, income, education, current nicotine replacement therapy use, and time since quitting. FINDINGS Vapers were more likely than non-vapers to report: 1) having smoked within five minutes of waking (34.3%vs.15.9%, AOR=3.74(95%CI:1.99,7.03), chi-square=16.92, p<0.001); having smoked >10 cigarettes/day (74.4%vs.47.2%, AOR=4.39(95%CI:2.22,8,68), chi-square=18.18,p<0.001); 2) perceiving themselves to be still very addicted to smoking (41.3%vs.26.2%, AOR=2.89(95% CI:1.58,5.30), chi-square=11.87, p<0.001) and feeling extremely confident about staying quit (62.1%vs.36.6%, AOR=3.22(95% CI:1.86,5.59), chi-square=17.36,p<0.001). Vapers were not more likely to report any urges to smoke than non-vapers (27.7%vs.38.8%, AOR=0.86(95% CI:0.44,1.65), chi-square=0.21,p=0.643). CONCLUSIONS While former smokers who currently vape nicotine daily report higher levels of cigarette smoking dependence pre- and post-cessation, compared with former smokers who are current non-vapers, they report greater confidence in staying quit and similar strength of urges to smoke.