Objective American Indians (AI) have a high prevalence of electronic nicotine delivery system (ENDS) use. However, little information exists on (ENDS) use, either alone or in combination with cigarettes (dual use), among AI. The objective of this small-scaled study was to examine use behaviours and dependence among exclusive ENDS users and dual users of AI descent. Exclusive smokers were included for comparison purposes.
Setting Oklahoma, USA.
Participants Adults of AI descent who reported being exclusive ENDS users (n=27), dual users (n=28) or exclusive cigarette smokers (n=27).
Measures Participants completed a detailed questionnaire on use behaviours. The Hooked on Nicotine Checklist (HONC) was used to assess loss of autonomy over cigarettes and was reworded for ENDS. Dual users completed the HONC twice. Sum of endorsed items indicated severity of diminished autonomy. Comparisons were made with non-parametric methods and statistical significance was defined as P<0.05.
Results Median duration of ENDS use was 2 years among ENDS users and 1 year among dual users. Most ENDS and dual users reported <20 vape sessions per day (72.0% vs 72.0%) with ≤10 puffs per vape session (70.4% vs 69.2%). Severity of diminished autonomy over ENDS was similar among ENDS and dual users (medians: 4 vs 3; P=0.6865). Among dual users, severity of diminished autonomy was lower for ENDS than cigarettes (medians: 3 vs 9; P=<0.0001). Comparing ENDS users with smokers, ENDS users had a lower severity of diminished autonomy (4 vs 8; P=0.0077). Comparing dual users with smokers, median severity of diminished autonomy over cigarettes did not differ (P=0.6865).
Conclusions Severity of diminished autonomy was lower for ENDS than cigarettes in this small sample of AI. Future, adequately powered studies should be conducted to fully understand ENDS use patterns and dependence levels in this population.
- public health
This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Statistics from Altmetric.com
Contributors Conceptualisation: DMC, TLW, DMT, LDS, JDP, JEC, LAB. Funding acquisition: DMC, TLW, LAB. Methodology: DMC, TLW, DMT, LDS, JDP, JEC, LAB. Project administration: DMC, LAB. Supervision: TLW, DMT, LDS, JDP, JEC, LAB. Data analysis: DMC, LAB. Writing of original draft: DMC, LAB. Review and editing: DMC, TLW, DMT, LDS, JDP, JEC, LAB.
Funding This work was supported by the National Institute on Drug Abuse at the National Institutes of Health (grant number 1R36DA042208-01). Facility support has been provided by the Oklahoma Shared Clinical and Translational Resources (grant number U54GM104938).
Competing interests None declared.
Ethics approval University of Oklahoma Health Sciences Center (No. 6317) and the Oklahoma City Area Indian Health Service Institutional Review Board (No. P-16-01-OK).
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement No additional data available.
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.