Institute of Social and Preventive Medicine - Faculty of Medicine - University of Geneva - Switzerland


Questionnaire for users of electronic cigarettes, page 2 of 3

When did you first use an electronic cigarette ? I used an e-cig for the first time on :
Day:
Month:
Year:
When did you last use an electronic cigarette ? I used an e-cig for the last time on:
(if you are a current user, please indicate today's date)
Day:
Month:
Year:
How old were you when you first started to use the electronic cigarette daily ? I was years old
How long did your current or most recent episode of electronic cigarette use last? It lasted:
In total (all episodes summed), during your life, for how long did you use the electronic cigarette? For in total
In the morning, usually, how soon after waking up do you use the electronic cigarette? minutes
Currently, on how many days per week do you use the electronic cigarette? I use it on days per week
Do you use the e-cigarette mainly during week days (Monday to Friday) or mainly during weekends (from Friday night to Sunday)?
Currently how many puffs per day do you draw on your electronic cigarette, on average? puffs per day
Before using the electronic cigarette, how many cigarettes did you smoke per day, on average? I smoked cig./day before using e-cigs
What equipment do you currently use most?

A- A disposable e-cigarette (non-rechargeable)
B- A commercial e-cigarette kit (with rechargeable battery)
C- A modular system (I use my own combination of separate devices: batteries, atomizers, etc.)

I use most:
What brand and model of electronic cigarette do you currently use most?
- If you've stopped using the electronic cigarette, indicate the brand(s) you used the most.
- Please also rate the quality of this model.

E-cig brand :
E-cig model :
Quality of this model :

How much did you pay for the electronic cigarette kit that you currently use most? (that is, the e-cig model you cited above) I paid: per kit
Please describe the "throat hit" of the e-cigarette you currently use most (that is, the e-cig model you cited above): Throat hit:
How many different brands of electronic cigarettes have you ever used? different brands of electronic cigarettes
One month ago, were you using the same brand of electronic cigarette as today?
Do you use cartridges that are already filled (ready to use), or a tank system, or do you add drops of liquid in your electronic cigarette ("drip")?
What brand, model and nicotine content of refill liquid do you currently use most for your electronic cigarette?
- If you've stopped using the electronic cigarette, indicate the e-liquid brand you used the most in the past..
- Please also rate this e-liquid.

E-liquid brand :
E-liquid model :
E-liquid nicotine content :
Satisfaction with this e-liquid model :

Please describe the "throat hit" of the e-liquid you currently use most (that is, the e-liquid you cited above): Throat hit:
How many different brands of refill liquids have you ever used? different brands or refill liquids
A month ago, were you using the same brand of refill liquid as today?
What brand, model and nicotine content of disposable pre-filled cartridges or cartomizers do you currently use most for your electronic cigarette?
- If you've stopped using the electronic cigarette, indicate the brand you used the most in the past.

Disposable pre-filled cartridge brand:
Disposable pre-filled cartridge model:
Disposable pre-filled cartridge nicotine content:
Satisfaction with this disposable pre-filled cartridge :

Please describe the "throat hit" of the disposable pre-filled cartridge or cartomizer you currently use most (that is, the cartridge model you cited above): Throat hit:
How many different brands of disposable pre-filled ccartridges / cartomizers have you ever used? different brands or disposable pre-filled cartrdiges / cartomizers
A month ago, were you using the same brand of disposable pre-filled cartridge or cartomizer as today?
For your refill liquid or cartridges, what flavor do you use most?


Other flavor:
Please rate the flavor you just mentioned above?


If you don't like this flavor, explain why?
What is the effect of this particular flavor on your smoking?


Does the refill liquid or cartridges that you currently use contain nicotine?
What is the concentration of nicotine in the liquid or cartridge that you are currently using, on average? Now: mg nicotine per milliliter
What was, on average, the concentration of nicotine in the liquid or cartridge that you used one month ago? One month ago: mg nicotine per milliliter
What is the capacity (in milliliters, mL) of the bottles of liquid that you use most to fill your electronic cigarettes? mL per bottle
How many milliliters (ml) of e-liquids do you use per month, on average? milliliters (ml) per month
Does the refill liquid (or cartridge) that you use most contain propylene glycol (PG), or vegetal glycerin (VG or glycerol), or a mix of PG and VG ?
Currently, how many times per day do you refill your electronic cigarette, on average? (That is, how many times a day do you add liquid or do you insert a new cartridge or cartomizer?) refills per day
Usually, how long does a refill or tank or cartridge of your electronic cigarette last before you need to refill it?
Please answer all 3 fields for this question
A containing of e-liquid
lasts minutes puffing
Usually, for how many puffs does a refill or tank or cartridge last ?
Please answer all 3 fields for this question
A containing of e-liquid produces on average puffs
Usually, how long (puffing) does the battery of your electronic cigarette last? The battery lasts hours puffing
Usually, for how many puffs does the battery of your electronic cigarette last? On average puffs per battery
How much do you spend monthly for your electronic cigarettes (purchase, refills, liquids, cartridges, batteries, components, etc..) I spend: per month
Where do you usually buy your electronic cigarettes ?
Where do you usually buy your refill liquids or cartridges?
On which website(s) do you buy your electronic cigarettes, devices and accessories (not e-liquids)? Websites for e-cigs:

1-
2-
3-

On which website(s) you buy your e-liquids? Websites for e-liquids:

1-
2-
3-

For how much longer do you intend to use the electronic cigarette? For still another
Have you ever used the electronic cigarette and tobacco on the same day?
If you did, why did you use tobacco and e-cigarettes on the same day?
Yes No
To decrease my tobacco use

In places where smoking is prohibited

Because I like using both tobacco and e-cigs

Did you ever modify your electronic cigarette?
If you did, please describe these "mods":
Did you ever replace the original battery of your electronic cigarette with a battery of a different type or size or capacity (in mAh)?
If you did, please describe:
Do you currently stock e-cigarette materials, just in case e-cigarette were prohibited in the future ?
Did you ever mix your own refill liquid for your electronic cigarette ?
If you did, please describe:
Did you ever add any substance to a commercial e-liquid and used this modified e-liquid ?
If you did, which substance(s) did you add to your refill liquid, and for how long did you use the e-cigarette to inhale this substance.? Substances:

Substance 1-
used for:

Substance 2-
used for

Substance 3-
used for

Did you ever use the electronic cigarette to inhale an illicit substance? (the real substance, not just an artificial flavor)
...to inhale:
Other illicit substance:
If you did, what is the effect of the e-cigarette on your use of this substance?
Did you ever use e-liquid with cannabis flavor? (artificial flavor, not real cannabis)
If you did, what is the effect of using an e-cig with artificial cannabis flavor on your use of real cannabis?

If you ever mixed you own refill liquid ("e-liquid" or "juice"), please indicate why:
(If you never did, please click here)
I mixed my own liquid to...

Not at all true

Not very true

Somewhat true

Very true

...to obtain a better flavor

...to decrease the concentration of nicotine

...to increase the concentration of nicotine

...to obtain a better "throat hit"

...because the modified liquid is less expensive

...to produce more vapor

...to gradually reduce your nicotine intake

...and how do you mix your e-liquid?

  Yes  

  No  

...I add nicotine

...I add propylene glycol

...I add flavors

...I add vegetal glycerin

...I add another substance, specify:

Please list the ingredients in the e-liquid that you mix:

If you ever modified your electronic cigarette ("mods"), please indicate how and why:
(If you never did, please
click here)
I modified my e-cigarette to / because...

Not at all true

Not very true

Somewhat true

Very true

...to increase the battery life

...to increase the longevity of the atomizer

...to increase the longevity of my e-cigarette

...to increase the battery voltage

...to decrease the battery voltage

...to add a variable voltage system

...to add a low resistance atomizer (lower ohm value)

...to add a high resistance atomizer (higher ohm value)

...to replace the wick (describe how: )

...to increase the capacity (volume) of the reservoir or cartridge

...to decrease the amount of vapor

...to increase the amount of vapor

...to "drip" the liquid directly in the atomizer

...to obtain a better "throat hit"

...to obtain a better taste

...because the modified version is less expensive

Please describe your "mods":

Not at all true

Not very true

Somewhat true

Very true

What would you do if e-cigarettes or e-liquids were banned or prohibited?

Strongly disagree

Rather disagree

Rather agree

Strongly agree

...I would stop using e-cigarettes

...I would start smoking again (former smokers)

...I would smoke more tobacco (current smokers)

...I would act to reverse the ban (being active in an association, or vapers group, or political party)

...I would obtain e-cigs and e-liquids on the black market

...I would build my own e-cigs from commerciallly available spare parts ("do it yourself")

...I would produce my own e-liquids from commerciallly available ingredients ("do it yourself")

...I would travel to buy e-cigs and e-liquids in a foreign country

...I would use e-cigs without nicotine (if nicotine only was prohibited, but not nicotine-free e-cigs)

For what purpose or reason do you use, or have you used the electronic cigarette?
I use (used) the electronic cigarette ...

Not at all true

Not very true

Somewhat true

Very true

... because I enjoy it

... to deal with my craving for tobacco

... to quit smoking or avoid relapsing to smoking

... to deal with tobacco withdrawal symptoms

... to deal with situations or places where I cannot smoke (e.g. at home, at work, during business meetings, when visiting non-smoking friends, in a plane, bus or train, etc.)

... to avoid having to go outside to smoke

... to avoid bothering other people with tobacco smoke

... to reduce my tobacco consumption with NO intention to quit smoking

... to reduce my tobacco consumption in preparation of a quit attempt

... because it is less toxic than smoking tobacco

... because it is cheaper than smoking tobacco

Not at all true

Not very true

Somewhat true

Very true

... because in spite of my efforts, I am unable to stop using the electronic cigarette

... because I do not want to smell like smoke

...because all other smoking cessation methods failed

...to replace tobacco cigarettes

...because I have a disease or condition that prohibits me to smoke

...as a nicotine reduction tool, to gradually decrease to 0 mg nicotine

...as a replacement of tobacco with NO intention of quitting my nicotine intake

...because tobacco cigarettes smell bad

...because I am addicted to the electronic cigarette

...to deal with stress

...because electronic cigarettes help me control my weight

Other purpose or reason:

Not at all true

Not very true

Somewhat true

Very true

Effects and use of the electronic cigarette:
Does (did) the electronic cigarette help you stop smoking?
Does (did) the electronic cigarette help you reduce your smoking? (That is, does it help you smoke fewer cigarettes?)
Did you ever recommend the electronic cigarette to other people (friend, colleague, etc.)?
Do you consider that some people (friends, colleagues, etc.) started tu use the electronic cigarette because of your recommendation or because of your example? ...started to vape because of my recommendation / example
Are you satisfied with the electronic cigarette?

Not at all = 0
Extremely = 10

satisfied
Does the electronic cigarette irritate your throat?
If it does, does it irritate your throat more with e-liquids that contain nicotine, or with those without nicotine? It irritates my throat more...
If it does, does it irritate your throat more with e-liquids that contain propylene glycol (PG), or with liquids that contain vegetal glycerin / glycerol (VG)? It irritates my throat more with liquids that contain...
Did the electronic cigarette ever cause you nosebleeds?
Did you notice any unwanted effects of the electronic cigarette? Specify:
If you have stopped using any electronic cigarette, why did you stop?

I stopped using the electronic cigarette ...

... because it did not work, I still had cravings and withdrawal symptoms


... because I didn't need it anymore
... because I didn't like it (specify)
Why didn't you like it?
... because the electronic cigarette did not help me quit smoking
... because of the poor quality of this product
...because the battery did not last long enough
...because I did not like its taste / flavors
...because I was not getting enough nicotine
...because it did not produce enough vapor
...because I still craved tobacco cigarettes
... because I feared the side effects of this product
... because I relapsed to smoking
... because I thought I would not relapse to smoking, even if I stopped the electronic cigarette
... because I replaced it with a smoking cessation medication (e.g. nicotine replacement therapy, Zyban/Wellbutrin or Champix/Chantix)
... other reason, please specify

Please indicate whether you agree with each statement:

Strongly disagree

Rather disagree

Feel neutral

Rather agree

Strongly agree

I am afraid that smoking will give me lung cancer

Most of my relatives disapprove of my smoking

The smell of tobacco smoke disgusts me

Smoking gives me very bad breath

I still feel the urge to smoke when using the electronic cigarette

It's easy to abstain from smoking when using the electronic cigarette

I fear that the electronic cigarette might be toxic

I like the taste of the vapor produced by my electronic cigarette

I like the sensation that I feel when I inhale the vapor of my electronic cigarette

I use the electronic cigarette because it does not produce any bad odors

The electronic cigarette causes me a dry mouth or dry throat

Strongly disagree

Rather disagree

Feel neutral

Rather agree

Strongly agree

I like the gesture of "vaping" (=using an electronic cigarette)

Since I began using the electronic cigarette, I cough less

Since I began using the electronic cigarette, I'm less breathless after exercising

Since I began using the electronic cigarette, I have more pleasant breath

Since I began using the electronic cigarette, I am more able to taste food and smell things

The electronic cigarette should act more quickly (it should provide faster relief of craving for tobacco)

The electronic cigarette should provide more nicotine

The vapor supplied by the electronic cigarette should be more concentrated

It should be easier to draw (inhale) on the electronic cigarette

I fear that I will start smoking again if I stopped using the electronic cigarette

I am afraid of becoming addicted to the electronic cigarette

Please suggest how to improve the electronic cigarette:

Strongly disagree

Rather disagree

Feel neutral

Rather agree

Strongly agree

Comments:

Please click below to send your answers:


[Created by JF Etter, version 1, 10 September 2012]