Preliminary characterization of the timecourse and magnitude of e-cigarette withdrawal among exclusive e-cigarette users: Findings from a supervised withdrawal study.

OBJECTIVE: Electronic cigarettes (e-cigarettes) have risen in popularity in the U.S. While e-cigarettes have shown promise as a viable smoking cessation aid, e-cigarette use is also associated with negative health consequences. Withdrawal from e-cigarettes may provide a barrier to quitting use; however, there is limited empirical research on the timecourse and experience of e-cigarette withdrawal. METHODS: Sixteen regular e-cigarette users completed a seven day, monitored abstinence period in Baltimore, MD (January 2024-May 2025). During this time, measures of withdrawal-induced desire to use and anticipated relief, craving for e-cigarettes, and behavioral economic demand for e-cigarettes were taken at four daily timepoints. These measures were compared to each participants' baseline when they were using e-cigarettes as normal. RESULTS: Desire to use and anticipated relief on the Questionnaire of Smoking Urges showed a significant reduction beginning on Study Day 4, craving measures showed significant changes (consistent with reduced craving) beginning on Study Day 3, and reduced demand for e-cigarettes began on Study Day 2. All changes remained significantly different from baseline through discharge after one week. CONCLUSIONS: These findings indicate that e-cigarette withdrawal symptoms follow a relatively rapid trajectory and has implications for understanding barriers to e-cigarette cessation.