JMIR Publications

ABSTRACT

Background:

While e-cigarettes are popular, it is debated how addictive e-cigarettes are.

Objective:

Thus, the aim of our study was to investigate whether and how e-cigarette users report signs of addiction in e-cigarette online forums.

Methods:

We identified three large German-speaking e-cigarette online forums via Google search. Based on a netnographic approach, we used deductive content analysis to investigate posts in those forums. The data was coded with regard to the DSM-5 criteria for Substance Use Disorder.

Results:

Overall, 5,337 threads in three forums were screened and 451 threads containing relevant information were included in the analysis. Users reported experiencing signs of a Substance Use Disorder, for example, craving for e-cigarettes. However, our analysis yielded that users also reported the absence of typical signs, 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 signs was mostly experienced in contrast to prior tobacco smoking.

Conclusions:

This is the first study to use a netnographic approach to explore unfiltered self-reports of signs of addiction of e-cigarette users in online forums. As hypothesized, some but not all users reported subjective experiences that corresponded to the criteria of a Substance Use Disorder as defined by the DSM-5. Nevertheless, subjective reports also indicated that many e-cigarette users feel in control of their behavior, especially in contrast to their prior use of tobacco cigarettes. This research can guide the development of instruments to assess e-cigarette addiction.