PT - JOURNAL ARTICLE AU - Eric Soule AU - Maansi Bansal-Travers AU - Rachel Grana AU - Scott McIntosh AU - Simani Price AU - Jennifer B Unger AU - Kevin Walton TI - Electronic cigarette use intensity measurement challenges and regulatory implications AID - 10.1136/tobaccocontrol-2021-056483 DP - 2023 Jan 01 TA - Tobacco Control PG - 124--129 VI - 32 IP - 1 4099 - http://tobaccocontrol.bmj.com/content/32/1/124.short 4100 - http://tobaccocontrol.bmj.com/content/32/1/124.full SO - Tob Control2023 Jan 01; 32 AB - Assessing tobacco use intensity allows researchers to examine tobacco use in greater detail than assessing ever or current use only. Tobacco use intensity measures have been developed that are specific to tobacco products, such as asking smokers to report number of cigarettes smoked per day. However, consensus on electronic cigarette use intensity measures that can be used for survey research has yet to be established due to electronic cigarette product and user behavior heterogeneity. While some survey measures that attempt to assess electronic cigarette use intensity exist, such as examining number of ‘times’ using an electronic cigarette per day, number of puffs taken from an electronic cigarette per day, volume of electronic cigarette liquid consumed per day, or nicotine concentration of electronic cigarette liquid, most measures have limitations. Challenges in electronic cigarette measurement often stem from variations across electronic cigarette device and liquid characteristics as well as the difficulty that many electronic cigarette users have regarding answering questions about their electronic cigarette device, liquid, or behavior. The inability for researchers to measure electronic cigarette use intensity accurately has important implications such as failing to detect unintended consequences of regulatory policies. Development of electronic cigarette use intensity measures, though not without its challenges, can improve understanding of electronic cigarette use behaviors and associated health outcomes and inform development of regulatory policies.