Dataset Information

Associations between dual use of e-cigarettes and smoking cessation: A prospective study of smokers in England.

ABSTRACT:

Background

It has been claimed that use of e-cigarettes in combination with cigarettes outside of a quit attempt ('dual use') reduces quitting among smokers. This study aimed to assess whether dual e-cigarette users have lower smoking cessation rates than (i) exclusive cigarette smokers or (ii) dual users of nicotine replacement therapy (NRT) and cigarettes.

Methods

Prospective cohort study of 1,498 smokers in England. The independent variable was dual use of e-cigarettes (n = 292), dual use of NRT (n = 117), or exclusive smoking (n = 1089), assessed at baseline. Outcomes were overall quit rate, past-year quit attempts, and success of quit attempts at 12-month follow-up. Baseline sociodemographic and smoking-related covariates were included.

Results

Overall quit rates were not lower in dual e-cigarette users than exclusive smokers (OR = 1.31, 0.90-1.89). Dual users of e-cigarettes were more likely than exclusive smokers to make a quit attempt, but this difference was not significant after adjustment for covariates (OR = 1.27, 95%CI 0.95-1.69). Among those attempting to quit, success rates did not differ significantly. Dual users of e-cigarettes were less likely to make a quit attempt than dual users of NRT (OR = 0.61, 95%CI 0.38-0.98) but the success rate of quit attempts and overall quit rates did not differ significantly.

Conclusions

In England, dual use of e-cigarettes is not associated with reduced overall quit rates compared with exclusive smoking or dual use of NRT. However, dual use of e-cigarettes is associated with a slightly higher quit attempt rate than exclusive smoking but lower than dual use of NRT.

SUBMITTER: Jackson SE

PROVIDER: S-EPMC6970222 | biostudies-literature | 2020 Apr

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Associations between dual use of e-cigarettes and smoking cessation: A prospective study of smokers in England.

Jackson Sarah E SE Shahab Lion L West Robert R Brown Jamie J

Addictive behaviors 20191130

<h4>Background</h4>It has been claimed that use of e-cigarettes in combination with cigarettes outside of a quit attempt ('dual use') reduces quitting among smokers. This study aimed to assess whether dual e-cigarette users have lower smoking cessation rates than (i) exclusive cigarette smokers or (ii) dual users of nicotine replacement therapy (NRT) and cigarettes.<h4>Methods</h4>Prospective cohort study of 1,498 smokers in England. The independent variable was dual use of e-cigarettes (n = 292 ...[more]

PMID: 31841827

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Project description:IntroductionAn increasing number of parents use both e-cigarettes and cigarettes (dual users). Previous studies have shown that dual users may have higher rates of contemplating smoking cessation than parents who only smoke cigarettes. This study was aimed to assess the delivery of tobacco cessation treatment (prescription for nicotine replacement therapy and referral to the quitline) among parents who report being dual users vs. cigarette-only smokers.MethodsA secondary analysis of parent survey data collected between April and October 2017 at 10 pediatric primary care practices participating in a cluster-randomized controlled trial of the Clinical Effort Against Secondhand Smoke Exposure (CEASE) intervention was conducted. Parents were considered to be dual users of cigarettes and e-cigarettes if they reported smoking a cigarette, even a puff, in the past seven days and using an e-cigarette within the past 30 days. Parents were asked if they received a prescription for nicotine replacement therapy and referral to the quitline to help them quit from their child's clinician. Multivariable logistic regression examined factors (dual use, insurance status, relationship to the child, race, and education status of the parent) associated with delivery of smoking cessation treatment (receiving prescriptions and/or enrollment in quitline) to smoking parents. Further, we compared the rates of tobacco cessation treatment delivery to dual users in the usual-care control practices vs. intervention practices.ResultsOf 1007 smokers or recent quitters surveyed in the five intervention practices, 722 parents reported current use of cigarettes-only and 111 used e-cigarettes. Of these 111 parents, 82 (73.9%) reported smoking cigarettes. Parents were more likely to report receiving any treatment if they were dual users vs. cigarette-only smokers (OR 2.43, 95% CI 1.38, 4.29). Child's insurance status, parents' sex, education, and race were not associated with parental receipt of tobacco cessation treatment in the model. No dual users in the usual-care control practices reported receiving treatment. Discussion. Dual users who visited CEASE intervention practices were more likely to receive treatment than cigarette-only smokers when treatments were discussed. An increased uptake of tobacco cessation treatments among dual users reinforces the importance of discussing treatment options with this group, while also recognizing that cigarette-only smokers may require additional intervention to increase the acceptance rate of cessation assistance. This trial is registered with ClinicalTrials.gov, Identifier: NCT01882348.

Project description:IntroductionThis study aimed to examine how the proportion of dual users of cigarettes and e-cigarettes who use e-cigarettes in situations where smoking is not permitted has changed since e-cigarettes became popular in England, and to characterize those who do so.MethodsData were from 5081 adults in England who reported current smoking and current use of e-cigarettes ('dual users') participating in a nationally-representative monthly survey between April 2011 and February 2020. We modeled quarterly changes in prevalence of e-cigarette use in situations where smoking is not permitted and assessed multivariable associations with sociodemographic and smoking characteristics.ResultsBetween 2011 and 2020, prevalence of e-cigarette use in situations where smoking is not permitted followed a positive cubic trend, with a decelerating increase from an estimated 52.5% of dual users in Q2-2011 to 72.7% in Q3-2014, followed by a small decline to 67.5% in 2018, and subsequent increase to 74.0% in 2020. Odds were higher among those who were from more disadvantaged social grades, reported stronger smoking urges, or had made a past-year quit attempt, and lower among those who were aged at least 65 years (vs. 16-24 years), from the south (vs. north) of England, reported currently cutting down on their cigarette consumption or currently using nicotine replacement therapy.ConclusionsIn England, use of e-cigarettes in situations where smoking is not permitted is common among dual cigarette and e-cigarette users, has increased nonlinearly since 2011, and is particularly prevalent among those who are younger, disadvantaged, more addicted, have recently failed to quit, and are not attempting to cut down.ImplicationsThe ability to use nicotine in smoke-free settings appears to be an important part of the appeal of e-cigarettes. It is possible that if e-cigarette use was prohibited in public places, smokers may be deterred from using e-cigarettes alongside combustible tobacco, which could undermine quitting. Our results suggest disadvantaged and more addicted smokers would be disproportionately affected, suggesting such restrictions may contribute to inequalities in smoking and associated health outcomes.

Dataset Information

Associations between dual use of e-cigarettes and smoking cessation: A prospective study of smokers in England.

Background

Methods

Results

Conclusions

Publications

Associations between dual use of e-cigarettes and smoking cessation: A prospective study of smokers in England.

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