Compensatory Puffing in E-Cigarette Users: the Importance of Nicotine Concentrations and Device Characteristics
Dr Catherine F Kimber
Centre for Addictive Behaviours Research, Division of Psychology, School of Applied Sciences, London South Bank University
Smoking remains the leading most preventable cause of death worldwide. E-cigarettes (EC) are tobacco harm reduction products which can promote smoking cessation. Today around 3.6 million adults in Great Britain currently use an EC. There are many types of devices and nicotine concentrations available and empirical evidence suggest marked differences in the way in which they are used in comparison to tobacco cigarettes. Yet, little empirical work have directly explored the interactions between device types, puffing patterns and nicotine concentrations, and how these factors influence cessation are unknown. A long-established theory (self-titration) suggests that smokers regulate their nicotine intake by adjusting their puffing patterns to satisfy their nicotine needs. An important implication of this bio-behavioural mechanism means that when switching to lower nicotine concentrations, smokers will compensate by increasing their puffing patterns thereby exposure to smoke and toxicants; thus compensatory puffing can translate into both financial and health costs. Although, well documented in tobacco smokers, self-titration has been underexplored in e-cigarettes use.
Data will be presented, from lab-based and real-world settings studies, documenting clear evidence of compensatory puffing in experienced EC users and attempts to self-titrate by EC-naïve smokers. Using longitudinal studies, the key roles of i) device types in providing satisfaction and predicting success in smoking cessation outcomes and, ii) nicotine concentrations in reducing craving for tobacco cigarettes, will be discussed. Data presented will also unveil the subtle nuances between satisfaction and craving and their predictive utility for smoking cessation. In addition, longitudinal data will highlight how experienced EC users reduce their nicotine concentrations over time, yet increase their nicotine e-liquid consumption whilst maintaining their nicotine intake (cotinine levels). Policy implications of this work will be discussed.
Dr Kimber graduated with a First Class BSc (hon) degree in Psychology with International Tourism Management in 2014 and completed her PhD in 2019 in the School of Psychology at University of East London. She has been conducting research on nicotine use and smoking cessation for 6 years, with a particular focus on e-cigarettes. Her PhD explored the potential of e-cigarettes as smoking cessation/reduction aids, e-cigarette users’ puffing behaviours in response to varying nicotine concentrations (self-titration), and the effects of devices and users’ characteristics. She has disseminated her findings widely via academic conferences and published in the following areas: i) E-cigarettes health warning labels, ii) nicotine absorption, iii) compensatory puffing and its associated potential health risks and, iv) predictors of e-cigarette choice in smokers. Her research interest focuses on the impact of policies and regulatory framework on smokers’ behaviours, intentions and perceptions towards e-cigarettes.
Session Chair: Dr Kirstie Soar, Reader, School of Psychology
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