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Harlow AF, Cho J, Tackett AP, McConnell RS, Leventhal AM, Stokes AC, Barrington-Trimis JL. Motivations for E-cigarette use and associations with vaping frequency and smoking abstinence among adults who smoke cigarettes in the United States. Drug Alcohol Depend 2022; 238:109583. [PMID: 35907310 PMCID: PMC9994580 DOI: 10.1016/j.drugalcdep.2022.109583] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 07/13/2022] [Accepted: 07/17/2022] [Indexed: 11/03/2022]
Abstract
INTRODUCTION In observational studies, vaping daily is positively associated with cigarette smoking abstinence, while non-daily vaping is associated with less smoking abstinence (versus no e-cigarette use). It remains unknown whether cigarette smokers who vape daily have different motivations for using e-cigarettes than those who vape non-daily. METHODS Using latent class analysis and 10 self-reported reasons for vaping, we identified sub-groups of participants based on vaping motivations among 1544 adult (≥18 y) dual users of e-cigarettes and cigarettes at wave 4 of the Population Assessment of Tobacco and Health (2016-2018). We examined the association of motivation sub-groups with vaping frequency at wave 4, and subsequent cigarette smoking abstinence at wave 5 (2018-2019). Additional analyses examined the association of vaping frequency with smoking abstinence before and after adjustment for motivation sub-groups. RESULTS Four distinct sub-groups of e-cigarette users emerged, including 54 % of participants who were "Vaping Enthusiasts", 20 % who vaped for "Convenience and Social Acceptability", 10 % classified as "Experimenters", and 16 % who vaped for "Quitting Smoking and Harm Reduction." The Convenience and Social Acceptability sub-group were less likely than "Vaping Enthusiasts" (AOR=0.29, 95 %CI[0.20-0.42]) and "Quitting Smoking and Harm Reduction" (AOR=0.41, 95 %CI[0.24-0.71]) classes to vape daily (versus non-daily). Sub-groups were not associated with smoking abstinence after one year. Adjustment for motivation sub-groups did not attenuate a positive association of daily vaping with smoking abstinence. CONCLUSIONS Cigarette smokers who vaped for convenience and social acceptability were less frequent e-cigarette users than those with other vaping motivations. Vaping motivations were not associated with subsequent smoking abstinence.
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Affiliation(s)
- Alyssa F Harlow
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, 1845 N. Soto Street, Los Angeles, CA 90032, USA.
| | - Junhan Cho
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, 1845 N. Soto Street, Los Angeles, CA 90032, USA
| | - Alayna P Tackett
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, 1845 N. Soto Street, Los Angeles, CA 90032, USA
| | - Rob S McConnell
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, 1845 N. Soto Street, Los Angeles, CA 90032, USA
| | - Adam M Leventhal
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, 1845 N. Soto Street, Los Angeles, CA 90032, USA
| | - Andrew C Stokes
- Department of Global Health, Boston University School of Public Health, 715 Albany Street, Boston, MA 02118, USA
| | - Jessica L Barrington-Trimis
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, 1845 N. Soto Street, Los Angeles, CA 90032, USA
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Vickerman KA, Carpenter KM, Miles LN, Hsu JM, Watt KA, Brandon TH, Hart JT, Javitz HS, Wagener TL. Treatment development, implementation, and participant baseline characteristics: A randomized pilot study of a tailored quitline intervention for individuals who smoke and vape. Contemp Clin Trials Commun 2021; 24:100845. [PMID: 34568637 PMCID: PMC8449159 DOI: 10.1016/j.conctc.2021.100845] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 08/23/2021] [Accepted: 09/06/2021] [Indexed: 01/08/2023] Open
Abstract
Background Approximately 57,000 dual users of cigarettes and e-cigarettes call state tobacco quitlines in the U.S. each year. Methods This paper describes a behavioral intervention for dual users of cigarettes and e-cigarettes designed to increase cigarette abstinence. It also presents baseline data from a randomized pilot comparing the Enhanced E-cigarette Coaching (EEC) intervention with quitline treatment as usual (TAU). Oklahoma Tobacco Helpline callers were recruited at registration and randomized to EEC (n = 46) or TAU (n = 50). Treatment included 5 coaching calls and free nicotine replacement therapy (NRT). EEC treatment included enhanced e-cigarette assessment, education, a shared decision-making quit plan development approach, and tailored behavioral support. Results Participants averaged 40.6 years of age and 19.2 cigarettes per day; 85% smoked daily, 48% vaped daily, and 53% reported medium to high e-cigarette dependence. Most reported using e-cigarettes to quit (43%) or to cut down (26%) on smoking. Most had previously tried to quit smoking (91%) and had tried FDA-approved cessation medications (79%). Beliefs about vaping, NRT, and smoking included misinformation. After discussing the relative risks of NRT, vaping, and smoking, most EEC participants (89%) selected a quit plan that incorporated both NRT and vaping. Conclusions At baseline, most participants reported a history of failed quit attempts with NRT and were vaping to quit or cut down on smoking, but they may need more support to completely quit smoking. If the EEC improves smoking outcomes, it would provide needed guidance on behavioral support best practices for individuals who vape and want to quit smoking.
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Affiliation(s)
| | | | - Lyndsay N Miles
- Optum Health, 11000 Optum Circle; Eden Prairie, MN, 55344, USA
| | - Johnathan M Hsu
- TSET Health Promotion Research Center, University of Oklahoma Health Sciences Center, 655 Research Parkway, Suite 400, Oklahoma City, OK, 73104, USA
| | - Karen A Watt
- Optum Health, 11000 Optum Circle; Eden Prairie, MN, 55344, USA
| | - Thomas H Brandon
- H Lee Moffitt Cancer Center and Research Institute, 12902 Magnolia Drive, Tampa, FL, 33612-9497, USA
| | - Jonathan T Hart
- TSET Health Promotion Research Center, University of Oklahoma Health Sciences Center, 655 Research Parkway, Suite 400, Oklahoma City, OK, 73104, USA
| | - Harold S Javitz
- SRI International, 333 Ravenswood Avenue, Menlo Park, CA, 94025, USA
| | - Theodore L Wagener
- University of Oklahoma Health Sciences Center, 655 Research Parkway, Suite 400, Oklahoma City, OK, 73104, USA
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Airagnes G, Lemogne C, Le Faou AL, Matta J, Romanello L, Wiernik E, Melchior M, Goldberg M, Limosin F, Zins M. Do the associations between the use of electronic cigarettes and smoking reduction or cessation attempt persist after several years of use? Longitudinal analyses in smokers of the CONSTANCES cohort. Addict Behav 2021; 117:106843. [PMID: 33581677 DOI: 10.1016/j.addbeh.2021.106843] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 01/19/2021] [Accepted: 01/19/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION We examined whether duration of electronic cigarette (e-cigarette) use could be associated with smoking reduction or cessation attempt. METHODS 5,409 current smokers at baseline enrolled in the French CONSTANCES cohort in 2015 or 2016 were included. Duration of e-cigarette use was categorized as follows: never; former user for more than one year; former user for less than one year; new user for less than one year; return to use for less than one year; regular use for one to two years; regular use for more than two years. Two outcomes were considered at one-year of follow-up: change in the number of cigarettes per day and cessation attempt. RESULTS Compared to never users, former users had an increase in the number of cigarettes per day at follow-up (B = 0.95[95%CI:0.57-1.33] and B = 1.03[95%CI:0.47-1.59] for former users of more than one year and less than one year, respectively). Compared to never users, all categories of current users had a decrease in the number of cigarettes per day (B = -3.31[95%CI:-4.07;-2.54] and B = -4.18[95%CI:-5.06;-3.29] for new users of less than one year and users of more than two years, respectively). Compared to never users, former users had a decreased likelihood of cessation attempt (OR = 0.80[95%CI:0.67-0.95] and OR = 0.77[95%CI:0.60-0.99] for former users of more than one year and less than one year, respectively). Compared to never users, all categories of current users had an increased likelihood of cessation attempt (OR = 3.12[95%CI:2.32;4.19] and OR = 3.36[95%CI:2.39;4.72] for new users of less than one year and users of more than two years, respectively). CONCLUSIONS E-cigarette use was associated with smoking reduction and cessation attempt for individuals who have used it for less than one year and additional benefits are expected to occur with a longer duration of use. Former users of e-cigarettes had poorer outcomes than those who have never used them.
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Affiliation(s)
- Guillaume Airagnes
- AP-HP. Centre-University of Paris, Department of Psychiatry and Addictology, Paris, France; INSERM, Population-based Epidemiological Cohorts, UMS 011, Villejuif, France; University of Paris, Faculty of Medicine, Paris, France.
| | - Cédric Lemogne
- AP-HP. Centre-University of Paris, Department of Psychiatry and Addictology, Paris, France; University of Paris, Faculty of Medicine, Paris, France; Université de Paris, INSERM, Institut de Psychiatrie et Neurosciences de Paris (IPNP), UMR_S1266, Paris, France
| | - Anne-Laurence Le Faou
- AP-HP. Centre-University of Paris, Department of Psychiatry and Addictology, Paris, France; University of Paris, Faculty of Medicine, Paris, France
| | - Joane Matta
- INSERM, Population-based Epidemiological Cohorts, UMS 011, Villejuif, France
| | - Lucile Romanello
- INSERM, Population-based Epidemiological Cohorts, UMS 011, Villejuif, France
| | - Emmanuel Wiernik
- INSERM, Population-based Epidemiological Cohorts, UMS 011, Villejuif, France
| | - Maria Melchior
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, IPLESP, Équipe de Recherche en Épidémiologie Sociale, Paris, France
| | - Marcel Goldberg
- INSERM, Population-based Epidemiological Cohorts, UMS 011, Villejuif, France
| | - Frédéric Limosin
- AP-HP. Centre-University of Paris, Department of Psychiatry and Addictology, Paris, France; University of Paris, Faculty of Medicine, Paris, France; Université de Paris, INSERM, Institut de Psychiatrie et Neurosciences de Paris (IPNP), UMR_S1266, Paris, France
| | - Marie Zins
- INSERM, Population-based Epidemiological Cohorts, UMS 011, Villejuif, France; University of Paris, Faculty of Medicine, Paris, France
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Vickerman KA, Carpenter KM, Raskob MK, Nash CM, Vargas-Belcher RA, Beebe LA. Vaping and E-Cigarettes Within the Evolving Tobacco Quitline Landscape. Am J Prev Med 2021; 60:S142-S153. [PMID: 33663702 DOI: 10.1016/j.amepre.2020.07.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 06/22/2020] [Accepted: 07/10/2020] [Indexed: 12/11/2022]
Abstract
This article summarizes the vaping research literature as it pertains to tobacco quitlines and describes vaping assessment, treatment, and evaluation quitline practices. It also presents 2014-2018 registration data (vaping in the past 30 days, number of use days, use for quitting smoking, and intentions to quit vaping) from 24 public quitlines (23 states and District of Columbia) and 110,295 enrollees to employer-sponsored quitlines. Trends in vaping rates over time, by state, and by age group are described. Approximately 57,000 adult public quitline enrollees in the U.S. reported vaping at registration in 2018 (14.7% of enrollees). Most quitline participants who vape also smoke cigarettes and contact the quitline for smoking cessation support. Rates of reporting vaping and no combustible or smokeless tobacco use in the past 30 days are 0.5% of all public quitline participants (<3% of public quitline vaping product users). Data are not systematically available regarding the number of quitline participants who are seeking help quitting vaping and only vape (do not use combustible or smokeless tobacco). Few quitline participants (<1%) are youth aged <18 years, but more than a third (35%) report vaping. This paper outlines research and evaluation priorities to inform the future quitline treatment landscape with respect to vaping. The quitline community is positioned to increase the likelihood that vaping has a positive impact for adults who smoke through harm reduction or supporting cessation and has opportunities to expand impacts on youth and young adult vaping prevention and cessation.
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Affiliation(s)
| | | | | | | | | | - Laura A Beebe
- Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
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Wang RJ, Bhadriraju S, Glantz SA. E-Cigarette Use and Adult Cigarette Smoking Cessation: A Meta-Analysis. Am J Public Health 2021; 111:230-246. [PMID: 33351653 PMCID: PMC7811087 DOI: 10.2105/ajph.2020.305999] [Citation(s) in RCA: 181] [Impact Index Per Article: 60.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2020] [Indexed: 01/01/2023]
Abstract
Objectives. To determine the association between e-cigarette use and smoking cessation.Methods. We searched PubMed, Web of Science Core Collection, and EMBASE and computed the association of e-cigarette use with quitting cigarettes using random effects meta-analyses.Results. We identified 64 papers (55 observational studies and 9 randomized clinical trials [RCTs]). In observational studies of all adult smokers (odds ratio [OR] = 0.947; 95% confidence interval [CI] = 0.772, 1.160) and smokers motivated to quit smoking (OR = 0.851; 95% CI = 0.684, 1.057), e-cigarette consumer product use was not associated with quitting. Daily e-cigarette use was associated with more quitting (OR = 1.529; 95% CI = 1.158, 2.019) and less-than-daily use was associated with less quitting (OR = 0.514; 95% CI = 0.402, 0.665). The RCTs that compared quitting among smokers who were provided e-cigarettes to smokers with conventional therapy found e-cigarette use was associated with more quitting (relative risk = 1.555; 95% CI = 1.173, 2.061).Conclusions. As consumer products, in observational studies, e-cigarettes were not associated with increased smoking cessation in the adult population. In RCTs, provision of free e-cigarettes as a therapeutic intervention was associated with increased smoking cessation.Public Health Implications. E-cigarettes should not be approved as consumer products but may warrant consideration as a prescription therapy.
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Affiliation(s)
- Richard J Wang
- Richard J. Wang and Sudhamayi Bhadriraju were initially postdoctoral fellows in the Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of California San Francisco; Richard J. Wang subsequently joined the faculty as an assistant professor of medicine, and Sudhamayi Bhadriraju joined the pulmonary medicine staff at the Kaiser Permanente Medical Center, Redwood City, CA. Stanton A. Glantz was professor of medicine and director of the Center for Tobacco Control Research and Education at the University of California San Francisco
| | - Sudhamayi Bhadriraju
- Richard J. Wang and Sudhamayi Bhadriraju were initially postdoctoral fellows in the Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of California San Francisco; Richard J. Wang subsequently joined the faculty as an assistant professor of medicine, and Sudhamayi Bhadriraju joined the pulmonary medicine staff at the Kaiser Permanente Medical Center, Redwood City, CA. Stanton A. Glantz was professor of medicine and director of the Center for Tobacco Control Research and Education at the University of California San Francisco
| | - Stanton A Glantz
- Richard J. Wang and Sudhamayi Bhadriraju were initially postdoctoral fellows in the Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of California San Francisco; Richard J. Wang subsequently joined the faculty as an assistant professor of medicine, and Sudhamayi Bhadriraju joined the pulmonary medicine staff at the Kaiser Permanente Medical Center, Redwood City, CA. Stanton A. Glantz was professor of medicine and director of the Center for Tobacco Control Research and Education at the University of California San Francisco
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6
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Soule EK, Plunk AD, Harrell PT, Hayes RB, Edwards KC. Longitudinal Analysis of Associations Between Reasons for Electronic Cigarette Use and Change in Smoking Status Among Adults in the Population Assessment of Tobacco and Health Study. Nicotine Tob Res 2020; 22:663-671. [PMID: 30698815 PMCID: PMC7171285 DOI: 10.1093/ntr/ntz005] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Accepted: 01/15/2019] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Electronic cigarette (ECIG) use and changes in cigarette smoking status may be influenced by self-reported reasons for using ECIGs. METHODS We analyzed adult current and former cigarette smokers who were also current or former ECIG users at wave 1 (n = 3044) using wave 1 and wave 2 Population Assessment of Tobacco and Health Study data (2013-2015). Prevalence of reporting 13 reasons for ECIG use at wave 1 was examined and weighted logistic regressions were conducted predicting smoking status changes from wave 1 to wave 2. RESULTS Reasons for ECIG use ranged from 18.1% (people in the media or public figures use them) to 82.5% (they might be less harmful to people around me than cigarettes). From wave 1 to wave 2, 27.2% of former smokers (n = 249) became current smokers and 11.6% of current smokers (n = 246) became former smokers. Among wave 1 former smokers, using ECIGs because of the availability of flavors (AOR = 0.57, 95% CI = 0.39-0.85) or because they don't smell (AOR = 0.64, 95% CI = 0.42-0.97) was associated with lower odds of relapse to smoking, but using ECIGs because using them helps people quit smoking (AOR = 1.55, 95% CI = 1.01-2.38) was associated with greater odds of relapse. Among wave 1 current smokers, using ECIGs because they can be used where smoking is not allowed (AOR = 0.56, 95% CI = 0.38-0.85) was associated with reduced odds of quitting cigarettes. CONCLUSIONS Some reasons for ECIG use are associated with changes in self-reported smoking status. Researchers should examine ECIG user characteristics when assessing associations between ECIG use and smoking status transitions. IMPLICATIONS Given that certain reasons for ECIG use, such as using ECIGs in locations are where smoking is not allowed, may inhibit smoking reduction, policies may be developed to prevent ECIG use in locations where smoking is banned. In addition, because certain reasons for ECIG use may aid in relapse prevention, such as availability of desired flavors, efforts should be made to identify ECIG device characteristics that are appealing to smokers but not youth or nontobacco users. These results provide support for future research on reasons for ECIG use to inform regulatory policies.
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Affiliation(s)
- Eric K Soule
- Department of Health Education and Promotion, East Carolina University, Greenville, NC
| | - Andrew D Plunk
- Department of Pediatrics, Eastern Virginia Medical School, Norfolk, VA
| | - Paul T Harrell
- Department of Pediatrics, Eastern Virginia Medical School, Norfolk, VA
| | - Rashelle B Hayes
- Department of Psychiatry, Virginia Commonwealth University, Richmond, VA
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Martner SG, Dallery J. Technology-based contingency management and e-cigarettes during the initial weeks of a smoking quit attempt. J Appl Behav Anal 2019; 52:928-943. [PMID: 31578724 DOI: 10.1002/jaba.641] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 08/16/2019] [Indexed: 12/18/2022]
Abstract
Contingency management (CM) interventions are among the most effective behavioral interventions for smoking. This study assessed the effects of CM and electronic cigarettes (ECs) on smoking reductions and abstinence for durations of 30-36 days. Twelve participants were exposed to Baseline, EC alone, and EC + CM conditions. An internet-based platform was used to monitor smoking via breath carbon monoxide (CO) and deliver CM for smoking abstinence (CO ≤4 ppm). A Bluetooth-enabled EC monitored daily EC puffs. Abstinence rates were equivalent between EC (34.4%) and EC + CM (30.4%) conditions. Both conditions promoted smoking reductions. We observed an inverse correlation between smoking and EC puffs (r = -.62, p < .05). Results suggest the use of electronic cigarettes can promote smoking reductions and abstinence, and CM did not improve these outcomes. Larger magnitude consequences or tailoring EC characteristics (e.g., flavor) may have improved outcomes. Technology-based methods to collect intensive, longitudinal measures of smoking and electronic cigarette use may be useful to characterize their environmental determinants.
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Abstract
AbstractIntroductionEvidence is mixed on e-cigarette's effectiveness as a tobacco cessation aid. Research suggests that e-cigarette users face greater barriers to quitting tobacco.AimTo examine the association between e-cigarette use and tobacco cessation outcomes among quitline callers.MethodsWe examined 2,204 callers who enrolled and completed 7-month follow-up surveys between April 2014 and January 2017. We examined the association between any e-cigarette use and tobacco cessation. We also evaluated these relationships by e-cigarette use patterns between enrollment and 7-month follow-up: sustained, adopted, discontinued, and non-use. We used multivariable logistic regression to control for caller characteristics, tobacco history, and program utilization.ResultsOverall, 18% of callers reported using e-cigarettes at enrollment, follow-up, or both. Compared to non-users, e-cigarette users were more likely to be younger, non-Hispanic, and report a mental health condition. The adjusted odds of tobacco cessation were not statistically different for callers who used e-cigarettes compared to those who did not (adjusted odds ratios = 1.02, 95% confidence interval 0.79–1.32). Results were similar when examining cessation by patterns of e-cigarette use.ConclusionsE-cigarette use was not associated with tobacco cessation. This suggests that e-cigarette use may neither facilitate nor deter tobacco cessation among quitline callers. Future research should continue exploring how e-cigarette use affects quitting.
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Enyioha C, Meernik C, Ranney L, Goldstein AO, Sellman K, Kistler CE. Willingness-to-try various tobacco cessation methods among US adult cigarette smokers. Tob Prev Cessat 2019; 5. [PMID: 31579310 PMCID: PMC6774637 DOI: 10.18332/tpc/108555] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
INTRODUCTION METHODS RESULTS CONCLUSIONS
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Affiliation(s)
- Chineme Enyioha
- Department of Family Medicine, School of Medicine, University of North Carolina at Chapel, Hill, Chapel Hill, NC.,The Cecil G. Sheps Center for Health Services Research, University of North Carolina, at Chapel Hill, Chapel Hill, NC
| | - Clare Meernik
- Department of Family Medicine, School of Medicine, University of North Carolina at Chapel, Hill, Chapel Hill, NC.,Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Leah Ranney
- Department of Family Medicine, School of Medicine, University of North Carolina at Chapel, Hill, Chapel Hill, NC.,Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Adam O Goldstein
- Department of Family Medicine, School of Medicine, University of North Carolina at Chapel, Hill, Chapel Hill, NC.,Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | | | - Christine E Kistler
- Department of Family Medicine, School of Medicine, University of North Carolina at Chapel, Hill, Chapel Hill, NC.,The Cecil G. Sheps Center for Health Services Research, University of North Carolina, at Chapel Hill, Chapel Hill, NC.,Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
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10
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Weaver SR, Huang J, Pechacek TF, Heath JW, Ashley DL, Eriksen MP. Are electronic nicotine delivery systems helping cigarette smokers quit? Evidence from a prospective cohort study of U.S. adult smokers, 2015-2016. PLoS One 2018; 13:e0198047. [PMID: 29985948 PMCID: PMC6037369 DOI: 10.1371/journal.pone.0198047] [Citation(s) in RCA: 81] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Accepted: 05/12/2018] [Indexed: 11/24/2022] Open
Abstract
Background The potential of electronic nicotine delivery systems (ENDS) to reduce the cardiovascular and other disease risks of smoking is of great interest. While many smokers report using ENDS for cessation, their impact under real-world use patterns and conditions on adult smokers’ quitting behavior is uncertain. The objective of this study was to generate more recent and comprehensive evidence on the effect of “real world” ENDS use on the population quit rates of adult smokers while taking account of frequency and duration of use, device type, e-liquid flavor, and reasons for use. Methods and findings We conducted a population-based, prospective cohort study of a random probability sample of 1284 U.S. adult smokers recruited in August/September 2015 and re-contacted one-year later (September 2016) from GfK’s KnowledgePanel, a national, probability-based web-panel designed to be representative of non-institutionalized U.S. adults. Among the 1081 baseline smokers who remained members of KnowledgePanel, 858 completed the follow-up survey. The primary outcome was smoking abstinence for at least 30 days prior to follow-up. Secondary outcomes were making a quit attempt during the 12-month study period and number of cigarettes smoked per day at follow-up. The adjusted odds of quitting smoking were lower for those that used ENDS at baseline (9.4%, 95% CI = 5.22%-16.38%; AOR = 0.30, 95% CI = 0.13–0.72) compared to smokers who did not use at ENDS (18.9%, 95% CI = 14.24%-24.68%). Smokers who used ENDS daily at some point during the study period were also less likely to quit smoking than nonusers (AOR = 0.17; 95% CI = 0.04–0.82). Limited ability to draw causal inferences from the observational design and a lack of biochemical verification of quitting smoking or ENDS use are limitations of this study. Conclusions We found no evidence that ENDS use, within context of the 2015–2016 US regulatory and tobacco/vaping market landscape, helped adult smokers quit at rates higher than smokers who did not use these products. Absent any meaningful changes, ENDS use among adult smokers is unlikely to be a sufficient solution to obtaining a meaningful increase in population quit rates. Additional research is needed to reconcile the divergent literature and monitor the impact of ENDS in an environment of rapidly evolving markets and regulatory policies.
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Affiliation(s)
- Scott R. Weaver
- Division of Epidemiology & Biostatistics, School of Public Health, Georgia State University, Atlanta, GA, United States of America
- Tobacco Center of Regulatory Science (TCORS), School of Public Health, Georgia State University, Atlanta, GA, United States of America
- * E-mail:
| | - Jidong Huang
- Tobacco Center of Regulatory Science (TCORS), School of Public Health, Georgia State University, Atlanta, GA, United States of America
- Division of Health Management & Policy, School of Public Health, Georgia State University, Atlanta, GA, United States of America
| | - Terry F. Pechacek
- Tobacco Center of Regulatory Science (TCORS), School of Public Health, Georgia State University, Atlanta, GA, United States of America
- Division of Health Management & Policy, School of Public Health, Georgia State University, Atlanta, GA, United States of America
| | - John Wesley Heath
- Tobacco Center of Regulatory Science (TCORS), School of Public Health, Georgia State University, Atlanta, GA, United States of America
| | - David L. Ashley
- Tobacco Center of Regulatory Science (TCORS), School of Public Health, Georgia State University, Atlanta, GA, United States of America
- Division of Environmental Health, School of Public Health, Georgia State University, Atlanta, GA, United States of America
| | - Michael P. Eriksen
- Tobacco Center of Regulatory Science (TCORS), School of Public Health, Georgia State University, Atlanta, GA, United States of America
- Division of Health Management & Policy, School of Public Health, Georgia State University, Atlanta, GA, United States of America
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Tan ASL, Rees VW, Rodgers J, Agudile E, Sokol NA, Yie K, Sanders-Jackson A. Effects of exposure to anti-vaping public service announcements among current smokers and dual users of cigarettes and electronic nicotine delivery systems. Drug Alcohol Depend 2018; 188:251-258. [PMID: 29793189 PMCID: PMC6825509 DOI: 10.1016/j.drugalcdep.2018.04.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Revised: 03/28/2018] [Accepted: 04/01/2018] [Indexed: 01/06/2023]
Abstract
INTRODUCTION Anti-vaping public service announcements (PSAs) are intended to discourage vaping or use of electronic nicotine delivery systems (ENDS). However, vaping portrayals in PSAs may have unintended effects if they increase smoking or vaping urges. This study examined benefits and unintended effects of anti-vaping PSAs with vapor portrayals on smoking and vaping-related outcomes. METHODS Young adult smokers (N = 171) and dual users (N = 122) aged 21-30 years were randomly assigned to view: 1) anti-vaping PSAs with vapor; 2) anti-vaping PSAs without vapor; 3) physical activity PSAs; or 4) anti-smoking PSAs with smoking cues. Outcomes were changes in vaping and smoking urges before and after viewing PSAs, post-test vaping and smoking intentions in the next hour, and post-test intention to purchase ENDS and traditional cigarettes. RESULTS Smokers only: Exposure to anti-vaping PSAs with vapor (vs. physical activity) was associated with lower intention to vape and to purchase ENDS (ps < 0.001) and lower intention to smoke and purchase cigarettes (ps < 0.05). Exposure to anti-vaping PSAs with vapor (vs. PSAs without vapor and vs. anti-smoking PSAs with smoking cues) was associated with lower intention to vape in the next hour (ps < 0.05). Exposure to anti-vaping PSAs without vapor (vs. physical activity) was associated with lower change in vaping urge (p < 0.05) and intention to purchase ENDS (p < 0.001). Dual users: Exposure to anti-vaping PSAs without vapor (vs. anti-smoking PSAs) was associated with lower intention to purchase ENDS (p < 0.05). CONCLUSION Viewing anti-vaping PSAs with vapor was not associated with unintended effects and may have benefits on reducing smoking and vaping-related outcomes.
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Affiliation(s)
- Andy SL Tan
- Dana-Farber Cancer Institute, Population Sciences Division, Center for Community Based Research, Boston, USA,Harvard T.H. Chan School of Public Health, Department of Social and Behavioral Sciences, Boston, USA
| | - Vaughan W Rees
- Harvard T.H. Chan School of Public Health, Department of Social and Behavioral Sciences, Boston, USA
| | - Justin Rodgers
- Harvard T.H. Chan School of Public Health, Department of Social and Behavioral Sciences, Boston, USA
| | - Emeka Agudile
- Harvard T.H. Chan School of Public Health, Department of Social and Behavioral Sciences, Boston, USA
| | - Natasha A Sokol
- Harvard T.H. Chan School of Public Health, Department of Social and Behavioral Sciences, Boston, USA
| | - Kyeungyeun Yie
- Michigan State University, Department of Advertising and Public Relations, College of Communication Arts and Science, 404 Wilson Road, Lansing, MI
| | - Ashley Sanders-Jackson
- Michigan State University, Department of Advertising and Public Relations, College of Communication Arts and Science, 404 Wilson Road, Lansing, MI
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12
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Soule EK, Maloney SF, Guy MC, Eissenberg T, Fagan P. User-identified electronic cigarette behavioral strategies and device characteristics for cigarette smoking reduction. Addict Behav 2018; 79:93-101. [PMID: 29272713 DOI: 10.1016/j.addbeh.2017.12.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Revised: 12/01/2017] [Accepted: 12/07/2017] [Indexed: 12/01/2022]
Abstract
BACKGROUND There is limited evidence on how cigarette smokers use electronic cigarettes (ECIGs) for smoking cessation and reduction. This study used concept mapping, a participatory mixed-methods research approach, to identify ECIG use behaviors and device characteristics perceived to be associated with cigarette smoking cessation or reduction. METHODS Current ECIG users aged 18-64 were recruited from seven cities selected randomly from U.S. census tract regions. Participants were invited to complete concept mapping tasks: brainstorming, sorting and rating (n=72). During brainstorming, participants generated statements in response to a focus prompt ("A SPECIFIC WAY I HAVE USED electronic cigarettes to reduce my cigarette smoking or a SPECIFIC WAY electronic cigarettes help me reduce my cigarette smoking is…") and then sorted and rated the statements. Multidimensional scaling and hierarchical cluster analyses were used to generate a cluster map that was interpreted by the research team. RESULTS Eight thematic clusters were identified: Convenience, Perceived Health Effects, Ease of Use, Versatility and Variety, Advantages of ECIGs over Cigarettes, Cigarette Substitutability, Reducing Harms to Self and Others, and Social Benefits. Participants generated several statements that related to specific behavioral strategies used when using ECIGs for smoking reduction/complete switching behaviors such as making rapid transitions from smoking to ECIG use or using certain ECIG liquids or devices. Former smokers rated the Perceived Health Effects cluster and several behavioral strategy statements higher than current smokers. CONCLUSIONS These results help to identify ECIG use behaviors and characteristics perceived by ECIG users to aid in cigarette smoking cessation or reduction.
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Affiliation(s)
- Eric K Soule
- Center for the Study of Tobacco Products, Virginia Commonwealth University, United States; Virginia Commonwealth University, Department of Psychology, PO Box 980205, Richmond, VA 23298, United States.
| | - Sarah F Maloney
- Center for the Study of Tobacco Products, Virginia Commonwealth University, United States; Virginia Commonwealth University, Department of Psychology, PO Box 980205, Richmond, VA 23298, United States.
| | - Mignonne C Guy
- Center for the Study of Tobacco Products, Virginia Commonwealth University, United States; Virginia Commonwealth University, Department of African American Studies, PO Box 842509, Richmond, VA 23284, United States.
| | - Thomas Eissenberg
- Center for the Study of Tobacco Products, Virginia Commonwealth University, United States; Virginia Commonwealth University, Department of Psychology, PO Box 980205, Richmond, VA 23298, United States.
| | - Pebbles Fagan
- Center for the Study of Tobacco Products, Virginia Commonwealth University, United States; University of Arkansas for Medical Sciences, Fay W. Boozman College of Public Health, Department of Health Behavior and Health Education, 4301 West Markham Street #820, Little Rock, AR 72205, United States.
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13
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Villanti AC, Feirman SP, Niaura RS, Pearson JL, Glasser AM, Collins LK, Abrams DB. How do we determine the impact of e-cigarettes on cigarette smoking cessation or reduction? Review and recommendations for answering the research question with scientific rigor. Addiction 2018; 113:391-404. [PMID: 28975720 PMCID: PMC6947656 DOI: 10.1111/add.14020] [Citation(s) in RCA: 72] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Revised: 10/19/2016] [Accepted: 08/21/2017] [Indexed: 12/22/2022]
Abstract
AIMS To propose a hierarchy of methodological criteria to consider when determining whether a study provides sufficient information to answer the question of whether e-cigarettes can facilitate cigarette smoking cessation or reduction. DESIGN A PubMed search to 1 February 2017 was conducted of all studies related to e-cigarettes and smoking cessation or reduction. SETTINGS Australia, Europe, Iran, Korea, New Zealand and the United States. PARTICIPANTS AND STUDIES 91 articles. MEASUREMENTS Coders organized studies according to six proposed methodological criteria: (1) examines outcome of interest (cigarette abstinence or reduction), (2) assesses e-cigarette use for cessation as exposure of interest, (3) employs appropriate control/comparison groups, (4) ensures that measurement of exposure precedes the outcome, (5) evaluates dose and duration of the exposure and (6) evaluates the type and quality of the e-cigarette used. FINDINGS Twenty-four papers did not examine the outcomes of interest. Forty did not assess the specific reason for e-cigarette use as an exposure of interest. Twenty papers did not employ prospective study designs with appropriate comparison groups. The few observational studies meeting some of the criteria (duration, type, use for cessation) triangulated with findings from three randomized trials to suggest that e-cigarettes can help adult smokers quit or reduce cigarette smoking. CONCLUSIONS Only a small proportion of studies seeking to address the effect of e-cigarettes on smoking cessation or reduction meet a set of proposed quality standards. Those that do are consistent with randomized controlled trial evidence in suggesting that e-cigarettes can help with smoking cessation or reduction.
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Affiliation(s)
- Andrea C. Villanti
- The Schroeder Institute for Tobacco Research and Policy Studies, Legacy, Washington, DC, USA
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Vermont Center on Behavior and Health, Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - Shari P. Feirman
- The Schroeder Institute for Tobacco Research and Policy Studies, Legacy, Washington, DC, USA
| | - Raymond S. Niaura
- The Schroeder Institute for Tobacco Research and Policy Studies, Legacy, Washington, DC, USA
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jennifer L. Pearson
- The Schroeder Institute for Tobacco Research and Policy Studies, Legacy, Washington, DC, USA
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Allison M. Glasser
- The Schroeder Institute for Tobacco Research and Policy Studies, Legacy, Washington, DC, USA
| | - Lauren K. Collins
- The Schroeder Institute for Tobacco Research and Policy Studies, Legacy, Washington, DC, USA
| | - David B. Abrams
- The Schroeder Institute for Tobacco Research and Policy Studies, Legacy, Washington, DC, USA
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC, USA
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14
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Subialka Nowariak EN, Lien RK, Boyle RG, Amato MS, Beebe LA. E-cigarette use among treatment-seeking smokers: Moderation of abstinence by use frequency. Addict Behav 2018; 77:137-142. [PMID: 28992579 DOI: 10.1016/j.addbeh.2017.09.023] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Revised: 09/22/2017] [Accepted: 09/27/2017] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Emerging literature suggests that frequency of use of electronic cigarettes (e-cigarettes) may be an important moderating variable in the relationship between e-cigarette use and smoking cessation. However, few studies have focused specifically on treatment-seekers, a group that may differ in important ways from smokers in the general population. This study looks at the relationship between e-cigarette use frequency and abstinence among a sample of treatment-seeking tobacco users. METHODS Seven-month follow-up survey data from N=2760 treatment-seeking tobacco users who utilized statewide tobacco quitlines in three states were used to assess the relationship between 30-day point prevalence abstinence and e-cigarette use frequency at follow-up. E-cigarette use was examined in two ways. First, we looked at any use in the past 30days versus no use. Additionally, past 30-day e-cigarette use frequency was categorized into four groups: 0days, 1-5days - infrequent, 6-29days - intermediate, 30days - daily. Logistic regression models were constructed predicting 30-day point prevalence tobacco abstinence. RESULTS Both infrequent (AOR=0.35; CI=0.20-0.59) and intermediate (AOR=0.50; CI=0.32-0.80) past 30-day e-cigarette use were associated with lower rates of tobacco abstinence versus no past 30-day use. However, daily e-cigarette users (AOR=1.16; CI=0.71-1.70) had similar 30-day abstinence when compared to non-users. CONCLUSIONS Results from this study of treatment-seekers support findings from studies of general population tobacco users that suggest frequency of e-cigarette use is an important moderating variable in the relationship between e-cigarette use and tobacco cessation. Future studies should employ more refined measures of e-cigarette use.
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Affiliation(s)
| | - Rebecca K Lien
- Professional Data Analysts, Inc., 219 Main Street SE, Suite 302, Minneapolis, MN 55414, USA.
| | - Raymond G Boyle
- ClearWay Minnesota(SM), Two Appletree Square, 8011 34th Avenue South, Suite 400, Minneapolis, MN 55425, USA.
| | - Michael S Amato
- Truth Initiative®, 900 G Street, NW, Fourth Floor, Washington, DC 20001, USA.
| | - Laura A Beebe
- University of Oklahoma Health Sciences Center, Department of Biostatistics and Epidemiology, College of Public Health, 801 NE 13th Street, Oklahoma City, OK 73104, USA.
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15
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Prevalence of population smoking cessation by electronic cigarette use status in a national sample of recent smokers. Addict Behav 2018; 76:129-134. [PMID: 28802179 DOI: 10.1016/j.addbeh.2017.08.002] [Citation(s) in RCA: 102] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2017] [Revised: 07/18/2017] [Accepted: 08/02/2017] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Amid decreasing rates of cigarette smoking and a rise in e-cigarette use, there is a need to understand population patterns of use to inform tobacco control efforts and evaluate whether e-cigarettes may play a role in tobacco harm reduction. METHODS This study merged data from the 2014 and 2015 National Health Interview Survey (NHIS) and restricted the sample to recent smokers [i.e., current smokers and former smokers who quit in 2010 or later (n=15,532)]. Log-binomial regression estimated adjusted prevalence ratios (aPR) for being quit by e-cigarette use status (i.e., daily, some day, former trier, never). All analyses controlled for factors traditionally correlated with smoking cessation. RESULTS A quarter of the sample (25.2%) were former smokers. The prevalence of being quit was significantly higher among daily e-cigarette users compared to those who had never used e-cigarettes [52.2% vs. 28.2%, aPR: 3.15 (2.66, 3.73)]. Those who used e-cigarettes on some days were least likely to be former smokers (12.1%). These relationships held even after accounting for making a quit attempt and use of other tobacco products. CONCLUSIONS Among those with a recent history of smoking, daily e-cigarette use was the strongest correlate of being quit at the time of the survey, suggesting that some smokers may have quit with frequent e-cigarette use or are using the products regularly to prevent smoking relapse. However, the low prevalence of cessation among infrequent e-cigarette users highlights the need to better understand this subgroup, including the individual factors and/or product characteristics that may inhibit cessation.
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16
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O'Connor RJ, Rees VW, Rivard C, Hatsukami DK, Cummings KM. Internalized smoking stigma in relation to quit intentions, quit attempts, and current e-cigarette use. Subst Abus 2017; 38:330-336. [PMID: 28481713 DOI: 10.1080/08897077.2017.1326999] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Reducing the social acceptability of smoking is associated with lowered smoking prevalence. However, denormalization strategies can also contribute to the stigmatization that some smokers may feel about their smoking. Smoking stigma may be more acute if smokers are also members of other stigmatized groups, such as racial/ethnic minorities. This study examined correlates of smoking self- and felt-stigma and discrimination, among current smokers. METHODS Participants were recruited in the United States via a national commercial consumer panel to complete a cross-sectional, Web-based survey. Participants were 1528 current cigarette smokers aged 14 and older. Measures included the Internalized Stigma of Smoking Inventory (ISSI), Heaviness of Smoking Index, quit intentions, past-year quit attempts, and current use of electronic cigarettes (e-cigarettes). RESULTS Self-stigma was significantly associated with higher intent to quit in the next 6 months (odds ratio [OR] = 2.47, P < .01) and in the next 30 days (OR = 4.21, P < .01), relative to no intention to quit, as well as having made 1 or 2 quit attempts in the past year (OR = 1.60, P < .01) or 3 or more quit attempts (OR = 1.74, P < .01) and associated with daily e-cigarette use (OR = 1.73, P < .05). Felt-stigma was positively associated with intent to quit in the next 30 days (OR = 1.54, P < .01), having made 3 or more quit attempts in the past year (OR = 1.35, P < .01), and both daily (OR = 2.05, P < .05) and some-day (OR = 1.30, P < .05) e-cigarette use. Discrimination was associated only with increased odds of daily e-cigarette use (OR = 1.83, P < .05). CONCLUSIONS Smokers who reported greater feelings of stigmatization about their smoking were more likely to report having made recent quit attempts, report a stronger intention quit smoking in the future, and report use of e-cigarettes, suggesting that feelings of self-and felt-stigmatization are related to greater motivation to stop smoking.
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Affiliation(s)
- Richard J O'Connor
- a Department of Health Behavior , Roswell Park Cancer Institute , Buffalo , New York , USA
| | - Vaughan W Rees
- b Department of Social and Behavioral Sciences , Harvard T.H. Chan School of Public Health , Boston , Massachusetts , USA
| | - Cheryl Rivard
- a Department of Health Behavior , Roswell Park Cancer Institute , Buffalo , New York , USA
| | - Dorothy K Hatsukami
- c Department of Psychiatry , University of Minnesota , Minneapolis , Minnesota , USA
| | - K Michael Cummings
- d Department of Psychiatry and Behavioral Science , Medical University of South Carolina , Charleston , South Carolina , USA
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17
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The Relation between Frequency of E-Cigarette Use and Frequency and Intensity of Cigarette Smoking among South Korean Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14030305. [PMID: 28335449 PMCID: PMC5369141 DOI: 10.3390/ijerph14030305] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Revised: 02/28/2017] [Accepted: 03/10/2017] [Indexed: 11/16/2022]
Abstract
INTRODUCTION The prevalence of adolescent electronic cigarette (e-cigarette) use has increased in most countries. This study aims to determine the relation between the frequency of e-cigarette use and the frequency and intensity of cigarette smoking. Additionally, the study evaluates the association between the reasons for e-cigarette use and the frequency of its use. MATERIALS AND METHODS Using the 2015 Korean Youth Risk Behavior Web-Based Survey, we included 6655 adolescents with an experience of e-cigarette use who were middle and high school students aged 13-18 years. We compared smoking experience, the frequency and intensity of cigarette smoking, and the relation between the reasons for e-cigarette uses and the frequency of e-cigarette use. RESULTS The prevalence of e-cigarette ever and current (past 30 days) users were 10.1% and 3.9%, respectively. Of the ever users, approximately 60% used e-cigarettes not within 1 month. On the other hand, 8.1% used e-cigarettes daily. The frequent and intensive cigarette smoking was associated with frequent e-cigarette uses. The percentage of frequent e-cigarette users (≥10 days/month) was 3.5% in adolescents who did not smoke within a month, but 28.7% among daily smokers. Additionally, it was 9.1% in smokers who smoked less than 1 cigarette/month, but 55.1% in smokers who smoked ≥20 cigarettes/day. The most common reason for e-cigarette use was curiosity (22.9%), followed by the belief that they are less harmful than conventional cigarettes (18.9%), the desire to quit smoking (13.1%), and the capacity for indoor use (10.7%). Curiosity was the most common reason among less frequent e-cigarette users; however, the desire to quit smoking and the capacity for indoor use were the most common reasons among more frequent users. CONCLUSIONS Results showed a positive relation between frequency or intensity of conventional cigarette smoking and the frequency of e-cigarette use among Korean adolescents, and frequency of e-cigarette use differed according to the reason for the use of e-cigarettes.
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18
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Glasser AM, Collins L, Pearson JL, Abudayyeh H, Niaura RS, Abrams DB, Villanti AC. Overview of Electronic Nicotine Delivery Systems: A Systematic Review. Am J Prev Med 2017; 52:e33-e66. [PMID: 27914771 PMCID: PMC5253272 DOI: 10.1016/j.amepre.2016.10.036] [Citation(s) in RCA: 320] [Impact Index Per Article: 45.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Revised: 10/07/2016] [Accepted: 10/26/2016] [Indexed: 12/20/2022]
Abstract
CONTEXT Rapid developments in e-cigarettes, or electronic nicotine delivery systems (ENDS), and the evolution of the overall tobacco product marketplace warrant frequent evaluation of the published literature. The purpose of this article is to report updated findings from a comprehensive review of the published scientific literature on ENDS. EVIDENCE ACQUISITION The authors conducted a systematic review of published empirical research literature on ENDS through May 31, 2016, using a detailed search strategy in the PubMed electronic database, expert review, and additional targeted searches. Included studies presented empirical findings and were coded to at least one of nine topics: (1) Product Features; (2) Health Effects; (3) Consumer Perceptions; (4) Patterns of Use; (5) Potential to Induce Dependence; (6) Smoking Cessation; (7) Marketing and Communication; (8) Sales; and (9) Policies; reviews and commentaries were excluded. Data from included studies were extracted by multiple coders (October 2015 to August 2016) into a standardized form and synthesized qualitatively by topic. EVIDENCE SYNTHESIS There were 687 articles included in this systematic review. The majority of studies assessed patterns of ENDS use and consumer perceptions of ENDS, followed by studies examining health effects of vaping and product features. CONCLUSIONS Studies indicate that ENDS are increasing in use, particularly among current smokers, pose substantially less harm to smokers than cigarettes, are being used to reduce/quit smoking, and are widely available. More longitudinal studies and controlled trials are needed to evaluate the impact of ENDS on population-level tobacco use and determine the health effects of longer-term vaping.
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Affiliation(s)
- Allison M Glasser
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, District of Columbia.
| | - Lauren Collins
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, District of Columbia
| | - Jennifer L Pearson
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, District of Columbia
| | - Haneen Abudayyeh
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, District of Columbia
| | - Raymond S Niaura
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, District of Columbia; Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Georgetown University Medical Center, Lombardi Comprehensive Cancer Center, Washington, District of Columbia
| | - David B Abrams
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, District of Columbia; Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Georgetown University Medical Center, Lombardi Comprehensive Cancer Center, Washington, District of Columbia
| | - Andrea C Villanti
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, District of Columbia; Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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