| Summary: | Introduction
Electronic nicotine delivery system (ENDS) and liquid characteristics
affect nicotine and toxicant exposure and use behaviors. Little is known about
how adults who frequently use ENDS transition between ENDS device/liquid
groupings.
Methods
A total of 379 US adults (≥21 years) using ENDS frequently (≥5 days/
week) self-reported and uploaded photos of their most used ENDS device and
liquid in three waves of online surveys (May 2020 – November 2021). Device/
liquid grouping was defined by device (i.e. disposable/refillable tank/refillable
pod or cartridge/disposable pod or cartridge, adjustable/no adjustable settings)
and liquid (i.e. salt/freebase) characteristics. Participants using the same grouping
across waves were considered stable users.
Results
The most prevalent wave (W) 1 grouping was tank (freebase, adjustable
settings; 36.8%). From W1 to W3, the number of disposable device (salt, no
adjustable settings) users increased 156.4% and the number of disposable pod/
cartridge (salt, no adjustable settings) users decreased 15.2%. In W2 and W3,
compared to stable users, participants using tank (freebase, adjustable settings)
in W1 and another grouping in W2 and/or W3 reported significantly higher
nicotine concentrations (mg/mL) (W2: 15.1 vs 5.5, p<0.001; W3: 22.9 vs 5.6,
p<0.001) and lower device power (watt) (W2: 46.8 vs 58.7, p=0.02; W3: 34.0
vs 57.2, p<0.001).
Conclusions
Over a 1.5-year period, a rapid growth in disposable device (salt,
no adjustable settings) use and a decrease in disposable pod/cartridge (salt, no
adjustable settings) use were observed. Participants who transitioned from tank
(freebase, adjustable settings) to other groupings were more likely to increase
liquid nicotine concentration and reduce device power compared to stable users.
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