Gender differences in use and expectancies of e-cigarettes: Online survey results

Given the rapid increase in e-cigarette use, it is important to understand factors that may contribute to their initiation and maintenance. Because gender differences in tobacco use, product preferences, and expectancies are well established, similar gender differences may exist with e-cigarettes. The aim of this study was to identify gender differences among e-cigarette users in patterns of use, reasons for initiation and maintenance, and outcome expectancies regarding e-cigarettes.

Participants (N=1815) completed an online survey from August through November, 2013. We assessed sociodemographics, smoking and e-cigarette history and use, and expectancies about e-cigarettes.

We found gender differences in type of e-cigarette used, flavors used, nicotine dosage, source of information about e-cigarettes, place of purchase, and use of e-cigarettes where smoking is prohibited. In addition, males were more likely to report initiating e-cigarette use to quit smoking due to health concerns, whereas females were more likely to report initiation based on recommendations from family and friends. Males reported higher attributions for maintenance of e-cigarette use related to positive reinforcement (enjoyment), whereas females reported higher negative reinforcement attributions (stress reduction or mood management). Males reported more positive expectancies about e-cigarettes, including taste, social facilitation, and energy, whereas women rated e-cigarettes higher for weight control. Males also reported greater addiction-related e-cigarette expectancy than females.

Many of the gender differences with e-cigarettes parallel those previously found with traditional cigarette smoking. Although effect sizes associated with these differences were small, the results may help advance research and intervention development with respect to e-cigarette initiation, maintenance and cessation.