Electronic cigarette use and tobacco cessation in a state-based quitline.

Introduction:
This text is a research article that examines the association between electronic cigarette (e-cigarette) use and tobacco cessation among callers participating in a state-based quitline program. The study aims to assess this association among participants who reported using an e-cigarette at any time during their quit attempt and to investigate patterns of e-cigarette use in an exploratory analysis.

Key Points:

* The study used data from the Arizona Smokers’ Helpline (ASHLine) and included callers who received tobacco cessation assistance between April 2014 and June 2016.
* E-cigarette use was assessed by asking, "are you using e-cigarettes?" at enrollment and 7-month follow up.
* The primary outcome was tobacco cessation 7-months after enrollment, measured as self-reported, 30-day point prevalence abstinence.
* Additional covariates included demographic and tobacco use history variables, such as gender, age, race, ethnicity, education, chronic health status, mental health status, nicotine dependence, home smoking bans, confidence to quit, intention to quit, and program engagement variables.
* In the primary analysis, e-cigarette use was not associated with quitting, and this result remained when e-cigarette use was classified as any/no use or by categorical patterns of use.
* In the exploratory analysis, there were no significant differences in tobacco cessation outcomes for e-cigarette users who sustained, adopted, or discontinued use between enrollment and follow-up.
* The study controlled for co-morbid mental health conditions, which previous research has shown to be prevalent among quitline callers and associated with difficulty quitting.

Main Message:
The study found that e-cigarette use was not associated with tobacco cessation among callers participating in a state-based quitline program. This result suggests that e-cigarette use may neither facilitate nor deter tobacco cessation among quitline callers. The study also highlights the need to further explore how e-cigarette use may impact quitting, particularly in quitline settings where participants are actively seeking to quit tobacco. Given the variety of e-cigarette product types and recommendations around using e-cigarettes, it will be important for quitlines to determine how best to tailor coaching protocols to assist e-cigarette users in quitting tobacco.

Brady, B. R., Crane, T. E., O'Connor, P. A., Nair, U. S., & Yuan, N. P. (2019). Electronic cigarette use and tobacco cessation in a state-based quitline. Journal of Smoking Cessation, 14(3), 176– 185. Cambridge University Press.