Nicotine Dependence and Stress Susceptibility in E-Cigarette Smokers: The Korea National Health and Nutrition Examination Survey 2013–2017
	    		
		   		
		   			
		   		
	    	
    	- Author:
	        		
		        		
		        		
			        		Jae Yeol KIM
			        		
			        		
			        		
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			        		Hye Seon KANG
			        		
			        		;
		        		
		        		
		        		
			        		Jae-Woo JUNG
			        		
			        		;
		        		
		        		
		        		
			        		Sun Young JUNG
			        		
			        		;
		        		
		        		
		        		
			        		Hye Jung PARK
			        		
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			        		Jong Sook PARK
			        		
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			        		Joo Hun PARK
			        		
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			        		Sang Haak LEE
			        		
			        		;
		        		
		        		
		        		
			        		Eun Mi CHUN
			        		
			        		;
		        		
		        		
		        		
			        		Dong Il PARK
			        		
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			        		Jisook PARK
			        		
			        		;
		        		
		        		
		        		
			        		Hye Sook CHOI
			        		
			        		;
		        		
		        		
		        		
		        		
		        		
			        		
			        		Author Information
			        		
 - Publication Type:Original Article
 - From:Tuberculosis and Respiratory Diseases 2021;84(2):159-166
 - CountryRepublic of Korea
 - Language:English
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		        	Abstract:
			       	
			       		
				        
				        	 Background:E-cigarettes are steadily gaining popularity in Korea. However, the characteristics of e-cigarette smokers, especially nicotine dependence and stress susceptibility, have not been evaluated in comparison to those of nonsmokers or combustible cigarette smokers in Korea.  
				        	
Methods:In this study, 28,059 participants from the Korea National Health and Nutrition Examination Survey (2013–2017) were classified into the following three groups: non-smokers, smokers (current smokers and ex-smokers of combustible cigarettes only), and e-smokers (current smokers and ex-smokers of e-cigarettes regardless of combustible cigarette use).
Results:Among the participants, 16,980 (60.5%), 9,247 (33.0%), and 1,832 (6.4%) subjects were non-smokers, smokers, and e-smokers, respectively. E-smokers were younger, more educated, and had a higher household income than nonsmokers or smokers. The number of e-smokers who smoked within 5 minutes of waking up (31.5% vs. 19.8%, p<0.001) and who planned to quit smoking within 6 months (39.1% vs. 35.7%, p<0.05) was greater than that of smokers. E-smokers perceived stress as “very much” (7.0% vs. 4.4%, p<0.001) and “a lot” (29.1% vs. 20.5%, p<0.001) compared to non-smokers. Suicidal ideation (6.5% vs. 4.7%, p<0.001), plans (2.4% vs. 1.3%, p<0.001), and attempts (1.1% vs. 0.5%, p<0.001) were higher in e-smokers than in non-smokers. Depressive episodes in 1 year (14.2% vs. 11.4%, p<0.05) and suicidal plans (2.4% vs. 1.8%, p<0.05) were more frequent among e-smokers than among smokers.
Conclusion:E-smokers were younger, more educated, and had a higher income, but they were more dependent on nicotine and susceptible to stress than non-smokers and smokers. Smoking cessation counseling should be tailored according to the characteristics of e-smokers. 
            