Impact of e-cigarette use among a cohort of American Indian cigarette smokers: associations with cigarette smoking cessation and cigarette consumption.

Introduction:
This text is a summary of a research study examining the impact of e-cigarette use on smoking cessation and cigarette consumption among a cohort of American Indian cigarette smokers. The study aims to determine if e-cigarette use is associated with cigarette smoking cessation or reduction among this population. The study is an observational pilot cohort study that collected baseline survey and biomarker data among AI adults who smoke. After 18 months, they repeated data collection and asked about changes in cigarette smoking status and cigarettes per day (CPD).

Key Points:

* The study included 375 AI adults who smoke at baseline, and 214 of them returned for follow-up.
* Of those who quit smoking, 15% were baseline e-cigarette users, while among those who continued to smoke at follow-up, about 11% were baseline e-cigarette users (p=0.48).
* Among those who continued to smoke at follow-up, there was no overall decrease in CPD, nor a significant difference in change in CPD between baseline e-cigarette users and non-users (p=0.98).
* Participants who quit smoking had lower baseline salivary cotinine levels (p=0.02) and were more likely to report an intention to quit cigarette smoking at baseline (p<0.01).
* Income and marital status were the only variables significantly related to a change in CPD among those who did not quit smoking at follow-up (p<0.05).
* The study's findings suggest that e-cigarettes did not affect cigarette smoking cessation or reduction in cigarette consumption among this population.
* Identifying e-cigarette users among the smoking population may be an effective way to identify those interested in cigarette smoking cessation.

Main Message:
The study found that e-cigarette use at baseline was not associated with smoking cessation or a change in CPD in this cohort of AI adults who smoke after an 18-month follow-up period. While e-cigarette use may be an indication that some cigarette smokers use them in hopes of quitting smoking, more research is needed to understand how e-cigarettes may mitigate or modify readiness to quit smoking. Clinicians should be aware of this potential association and consider it in their approach to smoking cessation interventions. However, the study's limitations suggest that further research is needed to confirm these findings and establish the effectiveness of e-cigarettes as a smoking cessation aid among this population.

Comiford AL, Rhoades DA, Spicer P, et al. Impact of e-cigarette use among a cohort of American Indian cigarette smokers: associations with cigarette smoking cessation and cigarette consumption. Tobacco control. 2021;30(1):103-107. doi:10.1136/tobaccocontrol-2019-055338