Boston University Medical Center, Boston, MA
Oladimeji Akinboro , Rawad Elias , Stanley Madu Nwabudike , Oluseyi Balasire , Jamie S. Ostroff
Background: The prevalence of e-cigarette use, and its impact on smoking cessation, among cancer survivors in the United States is unknown. We sought to estimate the prevalence of e-cigarette use, and examine its associations with cigarette smoking and quit attempts among survivors of smoking-related cancer survivors in the United States. Methods: We obtained data from the 2014-2016 annual cycles of the National Health Interview Survey. Our study sample comprised 2,561 adults with self-reported lifetime histories of at least one smoking-related cancer. We calculated the prevalence rates of e-cigarette use among survivors of smoking-related cancers. Using a multivariable logistic regression model, we examined independent associations of cigarette smoking history with e-cigarette use while adjusting for sociodemographic and other patient variables that were associated with e-cigarette use from the bivariate analyses. Survey weights were applied in estimating the population-based prevalence rates, odds ratios (OR), and 95% confidence intervals (CI). Results: The prevalence of e-cigarette use among survivors of smoking-related cancers was 3.31% (95% CI 2.39%, 4.56%). Those aged 18-44 years had the highest rates of e-cigarette use of any age group (7.26%; 95% CI 2.80%, 11.72%; p-value for age: < 0.001). No associations were seen between e-cigarrete use and gender, race, presence of other smoking-related comorbidities, or duration of survival. Current cigarette smokers were 31 times as likely as never smokers to use e-cigarettes (OR 31.48; 95% CI 4.54, 218.16). Among current smokers, no association was seen between e-cigarette use and either the number of quit attempts or smoking cessation counselling by health professional in the prior year. Conclusions: E-cigarette use was highest among current smokers and relatively young survivors of smoking related cancers. The lack of association between e-cigarette use and smoking quit attempts supports observations that e-cigarettes do not increase smoking quit rates. This is concerning, and highlights the need for further studies to define the impact of e-cigarette use on smoking cessation, and long-term outcomes of survivors of smoking-related cancers.
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