E-cigarettes are steadily gaining popularity in Korea. However, the characteristics of e-cigarette smokers, especially their nicotine dependence and stress susceptibility have not been evaluated in comparison to those of non-smokers or combustible cigarettes smokers in Korea.
In this study, 28,059 participants from the Korea National Health and Nutrition Examination Survey (2013-2017) were classified into three groups: non-smokers, smokers (current- and ex-smokers of combustible cigarettes only), and e-smokers (current- and ex-smokers of e-cigarettes regardless of combustible cigarette use).
Among the participants, 16,980 (60.5%), 9,247 (33.0%), and 1,832 (6.4%) were non-smokers, smokers, and e-smokers, respectively. E-smokers were younger, more educated, and had a higher household income than non-smokers or smokers. The number of e-smokers smoking within 5 minutes of waking up (31.5% vs 19.8%, P<0.001) and planning 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) more than 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 episode 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.
E-smokers were younger, more educated, and had a higher income, but were more nicotine-dependent and susceptible to stress than non-smokers and smokers. Smoking cessation counseling should be tailored to the characteristics of e-smokers.