Addictive Potential of e-Cigarettes as Reported in e-Cigarette Online Forums: Netnographic Analysis of Subjective Experiences
While e-cigarettes usually contain nicotine, their addictive potential is not yet fully understood. We hypothesized that if e-cigarettes are addictive, users will experience typical symptoms of addiction. The aim of our study was to investigate whether and how e-cigarette users report signs of addic...
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| Published in: | Journal of medical Internet research Vol. 25; no. 1; p. e41669 |
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| Main Authors: | , , , , , , , |
| Format: | Journal Article |
| Language: | English |
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Canada
Gunther Eysenbach MD MPH, Associate Professor
06.01.2023
JMIR Publications |
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| ISSN: | 1438-8871, 1439-4456, 1438-8871 |
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| Abstract | While e-cigarettes usually contain nicotine, their addictive potential is not yet fully understood. We hypothesized that if e-cigarettes are addictive, users will experience typical symptoms of addiction.
The aim of our study was to investigate whether and how e-cigarette users report signs of addiction.
We identified 3 large German-language e-cigarette online forums via a systematic Google search. Based on a netnographic approach, we used deductive content analysis to investigate relevant posts in these forums. Netnography has the advantage of limiting the social desirability bias that prevails in face-to-face research, such as focus groups. The data were coded according to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) criteria for tobacco use disorder, adapted for e-cigarettes. The DSM-5 criteria were used to portray a broad spectrum of possible experiences of addiction.
Overall, 5337 threads in 3 forums were screened, and 451 threads containing relevant information were included in the analysis. Users reported experiences consistent with the DSM-5 criteria, such as craving e-cigarettes, excessive time spent vaping, and health issues related to e-cigarette use. However, our analysis also showed that users reported the absence of typical tobacco use disorder criteria, such as successful attempts to reduce the nicotine dosage. For most themes, reports of their absence were more frequent than of their presence. The absence of perceived addiction was mostly reported in contrast to prior tobacco smoking.
This is the first study to use a netnographic approach to explore unfiltered self-reports of experiences of e-cigarette addiction by users in online forums. As hypothesized, some but not all users reported subjective experiences that corresponded to the criteria of tobacco use disorder as defined by the DSM-5. Nevertheless, subjective reports also indicated that many e-cigarette users felt in control of their behavior, especially in contrast to their prior use of tobacco cigarettes. The finding that some e-cigarette users subjectively experience addiction highlights the need for effective cessation programs to support users who experience their e-cigarette use as burdensome. This research can guide the refinement of instruments to assess e-cigarette addiction and guide cessation programs.
RR2-10.1186/s40359-021-00682-8. |
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| AbstractList | While e-cigarettes usually contain nicotine, their addictive potential is not yet fully understood. We hypothesized that if e-cigarettes are addictive, users will experience typical symptoms of addiction.BACKGROUNDWhile e-cigarettes usually contain nicotine, their addictive potential is not yet fully understood. We hypothesized that if e-cigarettes are addictive, users will experience typical symptoms of addiction.The aim of our study was to investigate whether and how e-cigarette users report signs of addiction.OBJECTIVEThe aim of our study was to investigate whether and how e-cigarette users report signs of addiction.We identified 3 large German-language e-cigarette online forums via a systematic Google search. Based on a netnographic approach, we used deductive content analysis to investigate relevant posts in these forums. Netnography has the advantage of limiting the social desirability bias that prevails in face-to-face research, such as focus groups. The data were coded according to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) criteria for tobacco use disorder, adapted for e-cigarettes. The DSM-5 criteria were used to portray a broad spectrum of possible experiences of addiction.METHODSWe identified 3 large German-language e-cigarette online forums via a systematic Google search. Based on a netnographic approach, we used deductive content analysis to investigate relevant posts in these forums. Netnography has the advantage of limiting the social desirability bias that prevails in face-to-face research, such as focus groups. The data were coded according to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) criteria for tobacco use disorder, adapted for e-cigarettes. The DSM-5 criteria were used to portray a broad spectrum of possible experiences of addiction.Overall, 5337 threads in 3 forums were screened, and 451 threads containing relevant information were included in the analysis. Users reported experiences consistent with the DSM-5 criteria, such as craving e-cigarettes, excessive time spent vaping, and health issues related to e-cigarette use. However, our analysis also showed that users reported the absence of typical tobacco use disorder criteria, such as successful attempts to reduce the nicotine dosage. For most themes, reports of their absence were more frequent than of their presence. The absence of perceived addiction was mostly reported in contrast to prior tobacco smoking.RESULTSOverall, 5337 threads in 3 forums were screened, and 451 threads containing relevant information were included in the analysis. Users reported experiences consistent with the DSM-5 criteria, such as craving e-cigarettes, excessive time spent vaping, and health issues related to e-cigarette use. However, our analysis also showed that users reported the absence of typical tobacco use disorder criteria, such as successful attempts to reduce the nicotine dosage. For most themes, reports of their absence were more frequent than of their presence. The absence of perceived addiction was mostly reported in contrast to prior tobacco smoking.This is the first study to use a netnographic approach to explore unfiltered self-reports of experiences of e-cigarette addiction by users in online forums. As hypothesized, some but not all users reported subjective experiences that corresponded to the criteria of tobacco use disorder as defined by the DSM-5. Nevertheless, subjective reports also indicated that many e-cigarette users felt in control of their behavior, especially in contrast to their prior use of tobacco cigarettes. The finding that some e-cigarette users subjectively experience addiction highlights the need for effective cessation programs to support users who experience their e-cigarette use as burdensome. This research can guide the refinement of instruments to assess e-cigarette addiction and guide cessation programs.CONCLUSIONSThis is the first study to use a netnographic approach to explore unfiltered self-reports of experiences of e-cigarette addiction by users in online forums. As hypothesized, some but not all users reported subjective experiences that corresponded to the criteria of tobacco use disorder as defined by the DSM-5. Nevertheless, subjective reports also indicated that many e-cigarette users felt in control of their behavior, especially in contrast to their prior use of tobacco cigarettes. The finding that some e-cigarette users subjectively experience addiction highlights the need for effective cessation programs to support users who experience their e-cigarette use as burdensome. This research can guide the refinement of instruments to assess e-cigarette addiction and guide cessation programs.RR2-10.1186/s40359-021-00682-8.INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)RR2-10.1186/s40359-021-00682-8. Background:While e-cigarettes usually contain nicotine, their addictive potential is not yet fully understood. We hypothesized that if e-cigarettes are addictive, users will experience typical symptoms of addiction.Objective:The aim of our study was to investigate whether and how e-cigarette users report signs of addiction.Methods:We identified 3 large German-language e-cigarette online forums via a systematic Google search. Based on a netnographic approach, we used deductive content analysis to investigate relevant posts in these forums. Netnography has the advantage of limiting the social desirability bias that prevails in face-to-face research, such as focus groups. The data were coded according to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) criteria for tobacco use disorder, adapted for e-cigarettes. The DSM-5 criteria were used to portray a broad spectrum of possible experiences of addiction.Results:Overall, 5337 threads in 3 forums were screened, and 451 threads containing relevant information were included in the analysis. Users reported experiences consistent with the DSM-5 criteria, such as craving e-cigarettes, excessive time spent vaping, and health issues related to e-cigarette use. However, our analysis also showed that users reported the absence of typical tobacco use disorder criteria, such as successful attempts to reduce the nicotine dosage. For most themes, reports of their absence were more frequent than of their presence. The absence of perceived addiction was mostly reported in contrast to prior tobacco smoking.Conclusions:This is the first study to use a netnographic approach to explore unfiltered self-reports of experiences of e-cigarette addiction by users in online forums. As hypothesized, some but not all users reported subjective experiences that corresponded to the criteria of tobacco use disorder as defined by the DSM-5. Nevertheless, subjective reports also indicated that many e-cigarette users felt in control of their behavior, especially in contrast to their prior use of tobacco cigarettes. The finding that some e-cigarette users subjectively experience addiction highlights the need for effective cessation programs to support users who experience their e-cigarette use as burdensome. This research can guide the refinement of instruments to assess e-cigarette addiction and guide cessation programs.International Registered Report Identifier (IRRID):RR2-10.1186/s40359-021-00682-8 BackgroundWhile e-cigarettes usually contain nicotine, their addictive potential is not yet fully understood. We hypothesized that if e-cigarettes are addictive, users will experience typical symptoms of addiction. ObjectiveThe aim of our study was to investigate whether and how e-cigarette users report signs of addiction. MethodsWe identified 3 large German-language e-cigarette online forums via a systematic Google search. Based on a netnographic approach, we used deductive content analysis to investigate relevant posts in these forums. Netnography has the advantage of limiting the social desirability bias that prevails in face-to-face research, such as focus groups. The data were coded according to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) criteria for tobacco use disorder, adapted for e-cigarettes. The DSM-5 criteria were used to portray a broad spectrum of possible experiences of addiction. ResultsOverall, 5337 threads in 3 forums were screened, and 451 threads containing relevant information were included in the analysis. Users reported experiences consistent with the DSM-5 criteria, such as craving e-cigarettes, excessive time spent vaping, and health issues related to e-cigarette use. However, our analysis also showed that users reported the absence of typical tobacco use disorder criteria, such as successful attempts to reduce the nicotine dosage. For most themes, reports of their absence were more frequent than of their presence. The absence of perceived addiction was mostly reported in contrast to prior tobacco smoking. ConclusionsThis is the first study to use a netnographic approach to explore unfiltered self-reports of experiences of e-cigarette addiction by users in online forums. As hypothesized, some but not all users reported subjective experiences that corresponded to the criteria of tobacco use disorder as defined by the DSM-5. Nevertheless, subjective reports also indicated that many e-cigarette users felt in control of their behavior, especially in contrast to their prior use of tobacco cigarettes. The finding that some e-cigarette users subjectively experience addiction highlights the need for effective cessation programs to support users who experience their e-cigarette use as burdensome. This research can guide the refinement of instruments to assess e-cigarette addiction and guide cessation programs. International Registered Report Identifier (IRRID)RR2-10.1186/s40359-021-00682-8 While e-cigarettes usually contain nicotine, their addictive potential is not yet fully understood. We hypothesized that if e-cigarettes are addictive, users will experience typical symptoms of addiction. The aim of our study was to investigate whether and how e-cigarette users report signs of addiction. We identified 3 large German-language e-cigarette online forums via a systematic Google search. Based on a netnographic approach, we used deductive content analysis to investigate relevant posts in these forums. Netnography has the advantage of limiting the social desirability bias that prevails in face-to-face research, such as focus groups. The data were coded according to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) criteria for tobacco use disorder, adapted for e-cigarettes. The DSM-5 criteria were used to portray a broad spectrum of possible experiences of addiction. Overall, 5337 threads in 3 forums were screened, and 451 threads containing relevant information were included in the analysis. Users reported experiences consistent with the DSM-5 criteria, such as craving e-cigarettes, excessive time spent vaping, and health issues related to e-cigarette use. However, our analysis also showed that users reported the absence of typical tobacco use disorder criteria, such as successful attempts to reduce the nicotine dosage. For most themes, reports of their absence were more frequent than of their presence. The absence of perceived addiction was mostly reported in contrast to prior tobacco smoking. This is the first study to use a netnographic approach to explore unfiltered self-reports of experiences of e-cigarette addiction by users in online forums. As hypothesized, some but not all users reported subjective experiences that corresponded to the criteria of tobacco use disorder as defined by the DSM-5. Nevertheless, subjective reports also indicated that many e-cigarette users felt in control of their behavior, especially in contrast to their prior use of tobacco cigarettes. The finding that some e-cigarette users subjectively experience addiction highlights the need for effective cessation programs to support users who experience their e-cigarette use as burdensome. This research can guide the refinement of instruments to assess e-cigarette addiction and guide cessation programs. RR2-10.1186/s40359-021-00682-8. |
| Author | Andreas, Marike Szafran, Daria Görig, Tatiana Lohner, Valerie Mons, Ute Vollstädt-Klein, Sabine Grundinger, Nadja Schneider, Sven |
| AuthorAffiliation | 4 Mannheim Center for Translational Neurosciences Medical Faculty of Mannheim University of Heidelberg Mannheim Germany 1 Division of Public Health, Social and Preventive Medicine Center for Preventive Medicine and Digital Health Medical Faculty Mannheim, Heidelberg University Mannheim Germany 2 Department of Medical Informatics, Biometry and Epidemiology Friedrich-Alexander-Universität Erlangen-Nürnberg Erlangen Germany 5 Cardiovascular Epidemiology of Aging Department of Cardiology Faculty of Medicine and University Hospital Cologne, University of Cologne Cologne Germany 3 Department of Addictive Behavior and Addiction Medicine Central Institute of Mental Health, Medical Faculty of Mannheim University of Heidelberg Mannheim Germany |
| AuthorAffiliation_xml | – name: 1 Division of Public Health, Social and Preventive Medicine Center for Preventive Medicine and Digital Health Medical Faculty Mannheim, Heidelberg University Mannheim Germany – name: 4 Mannheim Center for Translational Neurosciences Medical Faculty of Mannheim University of Heidelberg Mannheim Germany – name: 5 Cardiovascular Epidemiology of Aging Department of Cardiology Faculty of Medicine and University Hospital Cologne, University of Cologne Cologne Germany – name: 2 Department of Medical Informatics, Biometry and Epidemiology Friedrich-Alexander-Universität Erlangen-Nürnberg Erlangen Germany – name: 3 Department of Addictive Behavior and Addiction Medicine Central Institute of Mental Health, Medical Faculty of Mannheim University of Heidelberg Mannheim Germany |
| Author_xml | – sequence: 1 givenname: Daria orcidid: 0000-0001-6387-7190 surname: Szafran fullname: Szafran, Daria – sequence: 2 givenname: Tatiana orcidid: 0000-0003-3435-1071 surname: Görig fullname: Görig, Tatiana – sequence: 3 givenname: Sabine orcidid: 0000-0002-6210-672X surname: Vollstädt-Klein fullname: Vollstädt-Klein, Sabine – sequence: 4 givenname: Nadja orcidid: 0000-0002-6721-0366 surname: Grundinger fullname: Grundinger, Nadja – sequence: 5 givenname: Ute orcidid: 0000-0003-1764-6783 surname: Mons fullname: Mons, Ute – sequence: 6 givenname: Valerie orcidid: 0000-0001-5589-9701 surname: Lohner fullname: Lohner, Valerie – sequence: 7 givenname: Sven orcidid: 0000-0001-6438-1971 surname: Schneider fullname: Schneider, Sven – sequence: 8 givenname: Marike orcidid: 0000-0003-3497-1107 surname: Andreas fullname: Andreas, Marike |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/36607713$$D View this record in MEDLINE/PubMed |
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| Copyright | Daria Szafran, Tatiana Görig, Sabine Vollstädt-Klein, Nadja Grundinger, Ute Mons, Valerie Lohner, Sven Schneider, Marike Andreas. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 06.01.2023. 2023. This work is licensed under https://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. Daria Szafran, Tatiana Görig, Sabine Vollstädt-Klein, Nadja Grundinger, Ute Mons, Valerie Lohner, Sven Schneider, Marike Andreas. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 06.01.2023. 2023 |
| Copyright_xml | – notice: Daria Szafran, Tatiana Görig, Sabine Vollstädt-Klein, Nadja Grundinger, Ute Mons, Valerie Lohner, Sven Schneider, Marike Andreas. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 06.01.2023. – notice: 2023. This work is licensed under https://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. – notice: Daria Szafran, Tatiana Görig, Sabine Vollstädt-Klein, Nadja Grundinger, Ute Mons, Valerie Lohner, Sven Schneider, Marike Andreas. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 06.01.2023. 2023 |
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| Keywords | substance use addiction smoking e-cigarette tobacco vaping netnographic analysis |
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| License | Daria Szafran, Tatiana Görig, Sabine Vollstädt-Klein, Nadja Grundinger, Ute Mons, Valerie Lohner, Sven Schneider, Marike Andreas. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 06.01.2023. This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on https://www.jmir.org/, as well as this copyright and license information must be included. |
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| Snippet | While e-cigarettes usually contain nicotine, their addictive potential is not yet fully understood. We hypothesized that if e-cigarettes are addictive, users... Background: While e-cigarettes usually contain nicotine, their addictive potential is not yet fully understood. We hypothesized that if e-cigarettes are... Background:While e-cigarettes usually contain nicotine, their addictive potential is not yet fully understood. We hypothesized that if e-cigarettes are... BackgroundWhile e-cigarettes usually contain nicotine, their addictive potential is not yet fully understood. We hypothesized that if e-cigarettes are... |
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| Title | Addictive Potential of e-Cigarettes as Reported in e-Cigarette Online Forums: Netnographic Analysis of Subjective Experiences |
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