Biochemically verified smoking cessation and vaping beliefs among vape store customers

Aims: To evaluate biochemically verified smoking status and electronic nicotine delivery systems (ENDS) use behaviors and beliefs among a sample of customers from vapor stores (stores specializing in ENDS).

Design, setting and participants: A cross-sectional survey of 215 adult vapor store customers at four retail locations in the Midwestern United States; a subset of participants (n = 181) also completed exhaled carbon monoxide (CO) testing to verify smoking status.

Measurements: Outcomes evaluated included ENDS preferences, harm beliefs, use behaviors, smoking history and current biochemically verified smoking status.

Findings: Most customers reported starting ENDS as a means of smoking cessation (86%), using newer-generation devices (89%), vaping non-tobacco/non-menthol flavors (72%) and using e-liquid with nicotine strengths of ≤20 mg/ml (72%). There was a high rate of switching (91.4%) to newer-generation ENDS among those who started with a first-generation product. Exhaled CO readings confirmed that 66% of the tested sample had quit smoking. Among those who continued to smoke, mean cigarettes per day decreased from 22.1 to 7.5 (P <0.001). People who reported vaping longer [odds ratio (OR) = 4.659, 95% confidence interval (CI) = 2.001-10.846], using newer-generation devices (OR = 2.950, 95% CI = 1.037-8.395) and using non-tobacco and non-menthol flavors (OR = 2.626, 95% CI = 1.133-6.085) were more likely to have quit smoking.

Conclusions: Among vapor store customers in the United States who use electronic nicotine delivery devices to stop smoking, vaping longer, using newer-generation devices and using non-tobacco and non-menthol flavored e-liquid appear to be associated with higher rates of smoking cessation.