E-Cigarette Design Preference and Smoking Cessation

A U.S. Population Study


      Electronic cigarette (e-cigarette) designs may be described as “closed” or “open.” Closed systems are disposable or reloadable with prefilled cartridges (cigalikes). Open systems feature a prominent chamber (tank), refillable with e-liquid. This study examined user design preference and its association with smoking cessation.


      A probability sample of current e-cigarette users (n=923) among adult ever smokers (n=6,560) in the U.S. was surveyed online between February 28 and March 31, 2014, and analyzed in September 2014. Photos of e-cigarette devices were presented alongside survey questions to facilitate respondents’ understanding of the questions.


      Most e-cigarette users were exclusive users of one design: 51.4% used only closed systems and 41.1% used only open systems, with 7.4% using both. Former smokers were more likely to use open systems than current smokers (53.8% vs 35.2%, p=0.002). Current smokers who attempted to quit in the last 12 months were more likely to use open systems than those who did not (41.4% vs 27.7%, p=0.029). Open system users were more likely than closed system users to use e-cigarettes daily (50.2% vs 22.9%, p<0.0001). Open system users were less likely to report their devices resembled (3.1% vs 73.0%, p<0.0001) or tasted like (29.1% vs 53.3%, p<0.0001) a cigarette but were more likely to report that their devices satisfied cravings than closed system users (82.8% vs 67.2%, p=0.001).


      Preference of e-cigarette design is associated with smoking cessation. A device’s ability to deliver more nicotine and its flexibility in use might contribute to users’ success in quitting smoking.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to American Journal of Preventive Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • King B.A.
        • Patel R.
        • Nguyen K.H.
        • Dube S.R.
        Trends in awareness and use of electronic cigarettes among us adults, 2010–2013.
        Nicotine Tob Res. 2015; 17: 219-227
        • CDC
        Tobacco use among middle and high school students—United States, 2011–2014.
        Morb Mortal Wkly Rep. 2015; 64: 381-385
        • Brown J.
        • West R.
        • Beard E.
        • Michie S.
        • Shahab L.
        • McNeill A.
        Prevalence and characteristics of e-cigarette users in Great Britain: findings from a general population survey of smokers.
        Addict Behav. 2014; 39: 1120-1125
        • Pauly J.
        • Li Q.
        • Barry M.B.
        Postscript: tobacco-free electronic cigarettes and cigars deliver nicotine and generate concern.
        Tob Control. 2007; 16 ( 357
      1. Esterl M. Big tobacco’s e-cigarette push gets a reality check. Wall Street Journal. August 26, 2014. Accessed February 25, 2016.

      2. Food and Drug Administration. Deeming Tobacco Products to Be Subject to the Federal Food, Drug, and Cosmetic Act, as Amended by the Family Smoking Prevention and Tobacco Control Act; Regulations on the Sale and Distribution of Tobacco Products and Required Warning Statements for Tobacco Products. 2014:23141–23207. Accessed October 20, 2014.

        • Dawkins L.
        • Kimber C.
        • Puwanesarasa Y.
        • Soar K.
        First- versus second-generation electronic cigarettes: predictors of choice and effects on urge to smoke and withdrawal symptoms.
        Addiction. 2015; 110: 669-677
        • Chen A.T.
        • Zhu S.-H.
        • Conway M.
        What online communities can tell us about electronic cigarettes and hookah use: a study using text mining and visualization techniques.
        J Med Internet Res. 2015; 17: e220
      3. R.J. Reynolds Vapor Company. VUSE: Digital vapor cigarettes. Published 2014. Accessed December 8, 2014.

        • Zhu S.-H.
        • Sun J.Y.
        • Bonnevie E.
        • et al.
        Four hundred and sixty brands of e-cigarettes and counting: implications for product regulation.
        Tob Control. 2014; 23: iii3-iii9
        • Brown C.J.
        • Cheng J.M.
        Electronic cigarettes: Product characterisation and design considerations.
        Tob Control. 2014; 23: ii4-ii10
        • Lechner W.V.
        • Meier E.
        • Wiener J.L.
        • et al.
        The comparative efficacy of first- versus second-generation electronic cigarettes in reducing symptoms of nicotine withdrawal.
        Addiction. 2015; 110: 862-867
        • Talih S.
        • Balhas Z.
        • Eissenberg T.
        • et al.
        Effects of user puff topography, device voltage, and liquid nicotine concentration on electronic cigarette nicotine yield: measurements and model predictions.
        Nicotine Tob Res. 2015; 17: 150-157
        • Vansickel A.R.
        • Eissenberg T.
        Electronic cigarettes: effective nicotine delivery after acute administration.
        Nicotine Tob Res. 2013; 15: 267-270
        • Farsalinos K.E.
        • Romagna G.
        • Tsiapras D.
        • Kyrzopoulos S.
        • Voudris V.
        Characteristics, perceived side effects and benefits of electronic cigarette use: a worldwide survey of more than 19,000 consumers.
        Int J Environ Res Public Health. 2014; 11: 4356-4373
        • Farsalinos K.E.
        • Romagna G.
        • Tsiapras D.
        • Kyrzopoulos S.
        • Spyrou A.
        • Voudris V.
        Impact of flavour variability on electronic cigarette use experience: an Internet survey.
        Int J Environ Res Public Health. 2013; 10: 7272-7282
        • Hitchman S.C.
        • Brose L.S.
        • Brown J.
        • Robson D.
        • McNeill A.
        Associations between e-cigarette type, frequency of use, and quitting smoking: findings from a longitudinal online panel survey in Great Britain.
        Nicotine Tob Res. 2015; 17: 1187-1194
        • Farsalinos K.E.
        • Romagna G.
        • Voudris V.
        Factors associated with dual use of tobacco and electronic cigarettes: a case control study.
        Nicotine Sci Regul Policy. 2015; 26: 595-600
      4. GfK. Knowledgepanel design summary. Published 2013.

        • Callegaro M.
        • DiSogra C.
        Computing response metrics for online panels.
        Public Opin Q. 2008; 72: 1008-1032
        • Yeager D.S.
        • Krosnick J.A.
        • Chang L.
        • et al.
        Comparing the accuracy of RDD telephone surveys and Internet surveys conducted with probability and non-probability samples.
        Public Opin Q. 2011; 75: 709-747
      5. GfK. Respondent Incentives. Published 2013. Accessed November 23, 2015.

        • U.S. Census Bureau, U.S. Bureau of Labor Statistics
        The Current Population Survey (CPS).
        U.S. Department of Commerce, Washington, DC2013
        • Jamal A.
        • Homa D.M.
        • O’Connor E.
        • et al.
        Current cigarette smoking among adults—United States, 2005–2014.
        Morb Mortal Wkly Rep. 2015; 64: 1233-1240
        • Lee E.S.
        • Forthofer R.N.
        Analyzing Complex Survey Data.
        2nd ed. Sage Publications, Thousand Oaks, CA2006
        • Farsalinos K.E.
        • Spyrou A.
        • Tsimopoulou K.
        • Stefopoulos C.
        • Romagna G.
        • Voudris V.
        Nicotine absorption from electronic cigarette use: comparison between first and new-generation devices.
        Sci Rep. 2014; : 4
        • Farsalinos K.E.
        • Romagna G.
        • Tsiapras D.
        • Kyrzopoulos S.
        • Voudris V.
        Evaluating nicotine levels selection and patterns of electronic cigarette use in a group of “vapers” who had achieved complete substitution of smoking.
        Subst Abuse Res Treat. 2013; 7: 139-146
      6. Hiler M, Kilgalen B, Breland A, Lipato T, Eissenberg T. Is an electronic cigarette user’s plasma nicotine concentration related to liquid nicotine concentration? In: SRNT 2015 Annual Meeting Final Program. POS1-44. Philadelphia, PA; 2015.

      7. Shihadeh AL, Eissenberg T. Factors influencing the toxicant content of electronic cigarette vapor: device characteristics and puff topography. In: Society for Research on Nicotine and Tobacco. Boston, MA; 2013.

        • Yingst J.M.
        • Veldheer S.
        • Hrabovsky S.
        • Nichols T.T.
        • Wilson S.J.
        • Foulds J.
        Factors associated with electronic cigarette users’ device preferences and transition from first generation to advanced generation devices.
        Nicotine Tob Res. 2015; 17: 1242-1246
        • Bandura A.
        Self-Efficacy: The Exercise of Control.
        W.H. Freeman, New York, NY1997
        • Biener L.
        • Hargraves J.L.
        A longitudinal study of electronic cigarette use among a population-based sample of adult smokers: association with smoking cessation and motivation to quit.
        Nicotine Tob Res. 2015; 17: 127-133
        • Farsalinos K.E.
        • Romagna G.
        • Tsiapras D.
        • Kyrzopoulos S.
        • Voudris V.
        Evaluation of electronic cigarette use (vaping) topography and estimation of liquid consumption: implications for research protocol standards definition and for public health authorities’ regulation.
        Int J Environ Res Public Health. 2013; 10: 2500-2514
        • Huang J.
        • Tauras J.
        • Chaloupka F.J.
        The impact of price and tobacco control policies on the demand for electronic nicotine delivery systems.
        Tob Control. 2014; 23: iii41-iii47
      8. Felberbaum M. For smokers, can e-cigarettes save money? Boston Globe. Published July 4, 2014. Accessed July 26, 2014.

      9. Chen A, Zhu S-H, Conway M. Mining Internet discussion forums to understand consumer experiences of hookah and electronic cigarettes. In: Proceedings of the State and Community Tobacco Control Meeting. Chicago, IL; 2014.

      10. blue Cigs. Published 2014. Accessed December 8, 2014.

      11. Green Smoke LLC. Green smoke. Published 2014. Accessed December 8, 2014.

      12. Nicocigs Ltd. Nicocig: The smoking alternative. Published 2014. Accessed December 8, 2014.

      13. Nu Mark LLC. MarkTen e-vapor. Published 2014. Accessed December 8, 2014.

        • Shihadeh A.
        • Eissenberg T.
        Electronic cigarette effectiveness and abuse liability: Predicting and regulating nicotine flux.
        Nicotine Tob Res. 2015; 17: 158-162
      14. Craver R. Reynolds American wants FDA to ban vapor e-cigs. Winston-Salem Journal. Published September 7, 2014. Accessed September 24, 2014.

      15. Zabala L, Stickney R. Man burned when E-cig explodes: officials. NBC 7 San Diego. Accessed March 5, 2015.

      16. Gara T. Are e-cigarettes losing ground in the vapor market? Corp Intell. Published April 2014. Accessed July 26, 2014.

      17. Eissenberg T, Shihadeh A. What standards do we need for new nicotine-delivery products? In: Society for Research on Nicotine and Tobacco: Annual Meeting Final Program. Philadelphia, PA; 2015.