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


Questionnaire for users of the electronic cigarette (page 3 of 3)

Questions for all (current, former, and never smokers):
The following statements describe how you feel TODAY:
Please rate yourself for TODAY: Does the electronic cigarette produce any relief of these feelings?
Desire or craving to smoke Does the e-cig relieve desire or craving to smoke ?
Anxious, nervous Does the e-cig relieve anxiety, nervousness?
Angry, irritable, frustrated Does the e-cig relieve anger, irritability, frustration?
Depressed mood, sad Does the e-cig relieve depressed mood, sadness?
Difficulty concentrating Does the e-cig relieve difficulty concentrating?
Insomnia, sleep problems, awakening at night Does the e-cig relieve insomnia, sleep problems, awakening at night?
Increased appetite, hungry, weight gain Does the e-cig relieve increased appetite, hunger, weight gain?
Restless, impatient Does the e-cig relieve restlessness, impatience?
Mood swings Does the e-cig relieve mood swings?
Coughing Does the e-cig relieve coughing?
Sore throat Does the e-cig relieve
sore throat?
Nosebleed Does the e-cig relieve
nosebleed?
Want to hold a cigarette between your fingers Does the e-cig relieve the need to hold a tobacco cigarette between your fingers

Please answer ALL questions:
When you first started to use the electronic cigarette, for how long did you intend to use it? I intended to use it...
Is it likely that, in one month from now, you will have stopped using the electronic cigarette?
If you decided to stop using the electronic cigarette, would you be likely to succeed in stopping using it?
In the past 12 months, have you made a serious attempt to stop using the electronic cigarette?
If you ever tried to stop using the electronic cigarette, how long did your most recent serious attempt to stop using it last? My last serious attempt to stop using
the e-cig lasted:
During the first week of your last attempt to stop using the electronic cigarette, did you feel the urge to use the electronic cigarette?
During the first week of your last attempt to stop using the electronic cigarette, did you feel the urge to smoke?

Please answer ALL questions:
For you, stopping using the electronic cigarette for good would be:
Do you find it difficult to refrain from using the electronic cigarette in places where it is prohibited (e.g. in a business meeting)?
Which puffs on your electronic cigarette would you hate most to give up?
Do you puff on your electronic cigarette more frequently during the first hours after waking than during the rest of the day?
Do you use the electronic cigarette when you are so ill that you are in bed most of the day?
Please rate your addiction to the electronic cigarette on a scale of 0 to 100:

I am NOT addicted to the electronic cigarette at all = 0
I am extremely addicted to the electronic cigarette = 100

Addiction to the e-cigarette (0-100)
How much of the time have you felt the urge to vape (=to use an electronic cigarette) today?
How strong have the urges been today?
Please rate your sense of smell for today:
Please rate your sense of taste for today:
Former smokers:
How would you rate your addiction to the electronic cigarette, compared with your addiction to tobacco cigarettes (when you were smoking)?
My addiction to the electronic cigarette is...

...than my addiction to tobacco cigarettes
Former smokers:
During a typical day, how much time do you currently spend vaping, compared with the amount of time that you spent smoking (when you were smoking)?
I now spend...

...than I spent smoking (when I was a smoker)

Questions for all:
Please indicate whether you agree with each of the following statements :
By "vaping" we mean taking puffs on the electronic cigarette

Totally disagree

Somewhat disagree

Neither agree nor disagree

Somewhat agree

Fully agree

After a few hours without using the electronic cigarette, I feel an irresistible urge to vape

The idea of not having any electronic cigarette causes me stress

Before going out, I always make sure that I have my electronic cigarette with me

I am a prisoner of the electronic cigarette

I vape too much

Sometimes I drop everything to vape

I vape all the time

I vape despite the risks to my health

I am unable to stop vaping

Totally disagree

Somewhat disagree

Neither agree nor disagree

Somewhat agree

Fully agree

Vaping calms me down when I am stressed

Vaping calms me down when I am upset

Vaping helps me deal with difficult situations

After vaping, I am able to concentrate better

It feels so good to vape !

I love vaping

I fear that I will start smoking again if I stopped vaping

I fear that I will gain weight if I stopped vaping

   

Totally disagree

Somewhat disagree

Neither agree nor disagree

Somewhat agree

Fully agree

Please tick the response option that indicates how well each of the following statements describes you :

Not at all True

Somewhat True

Moderately
True

Very True

Extremely True

1 After not vaping for a while, I need to vape to relieve feelings of restlessness and irritability

2 Whenever I go without vaping for a few hours, I experience craving for electronic cigarettes

3 After not vaping for a while, I need to vape in order to keep myself from experiencing any discomfort

4 When I'm really craving an electronic cigarette, it feels like I'm in the grip of some unknown force that I cannot control

5 I feel a sense of control over my use of the electronic cigarette, I can "take it or leave it" at any time

6 I tend to avoid places where I cannot use the electronic cigarette, even if I would otherwise enjoy the company

 

Not at all True

Somewhat True

Moderately
True

Very True

Extremely True

7 Sometimes I decline offers to visit with my friends because I know they would feel uncomfortable if I used the electronic cigarette

9 Since the time when I became a regular user of the electronic cigarette, the amount of puffs I draw on it has either stayed the same or has decreased somewhat

10 Compared to when I first started using the electronic cigarette, I need to puff on it a lot more now in order to really get what I want out of it

11 Compared to when I first started using the electronic cigarette, I can take many, many more puffs now before I start to feel nauseated or ill

12 It's hard to estimate how many puffs I draw per day because the number often changes

13 My pattern of vaping is very irregular throughout the day. It is not unusual for me to take many puffs in an hour, then not have another puff until hours later

 

Not at all True

Somewhat True

Moderately
True

Very True

Extremely True

14 The number of puffs I take per day is often influenced by other factors - how I'm feeling, what I'm doing, etc.

15 I vape at different rates in different situations

16 My  vaping is not much affected by other things. I vape about the same whether I'm relaxing or working, happy or sad, alone or with others, etc.

17 My vaping is fairly regular throughout the day

18 I vape consistently and regularly throughout the day

19 I take about the same amount of puffs on my electronic cigarette on weekends as on weekdays 

 

Not at all True

Somewhat True

Moderately
True

Very True

Extremely True

Please answer the following questions based on how you have felt or what you have noticed over the last 24 hours.
Answer based on how you have felt in general during this time :
Strongly disagree Disagree Feel neutral Agree Strongly agree
I have had frequent urges to vape

I have been bothered by the desire to use an electronic cigarette

I have thought about vaping a lot

I have trouble getting electronic cigarettes off my mind

The only thing I can think about is vaping

I miss electronic cigarettes terribly

I feel an irresistible need to vape

Comments on this survey, or further description of you experience with e-cigarettes:

Please click below to send your answers:


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