Smokers’ use of electronic cigarettes before, during, and in the month after hospitalization. Findings from the helping haND 2 Study.

Introduction:
This text is a secondary analysis of the helping haND 2 (hh2) randomized controlled trial, which aimed to compare the effectiveness of a post-discharge treatment recommendation versus free comprehensive cessation treatment intervention. The study focused on e-cigarette use before, during, and after hospitalization among cigarette smokers admitted to three hospitals.

Key Points:

* The study enrolled 1357 cigarette smokers, and 1100 completed the 1-month follow-up assessment.
* Past 30-day e-cigarette use was reported by 21.4% of all participants before hospitalization.
* During hospitalization, 3.1% of participants reported using e-cigarettes, with 91% of them using e-cigarettes inside the hospital building.
* at the 1-month follow-up, 18.3% of participants used e-cigarettes at any point after hospitalization.
* higher aUDIT scores, lower confidence to quit, and use of e-cigarettes before hospitalization were positively associated with current e-cigarette use at 1-month post-discharge.
* Being non-hispanic black, having Medicaid insurance, and being randomized to receive easier access to cessation support were negatively associated with current e-cigarette use post-discharge.
* Most participants used e-cigarettes primarily as aids to quitting, and few participants switched completely to e-cigarettes.

Main Message:
The study suggests that patients who plan to quit but are less confident in their ability to do so, may have higher income, and are not provided with easy access to conventional treatment may choose to use e-cigarettes, particularly if they have prior experience with e-cigarette use. Clinicians should assess e-cigarette use routinely among patients, inform patients about the uncertainty of e-cigarettes as cessation aids, encourage patients to use evidence-based treatments first, and emphasize the need to cease using conventional tobacco altogether. Further research is needed to develop more comprehensive interventions that consider smokers' beliefs about the effectiveness and safety of e-cigarettes.

herbeć aa, Chang Y, Tindle ha, Rigotti Na. Smokers’ use of electronic cigarettes before, during, and in the month after hospitalization. Findings from the helping haND 2 Study. addictive Behaviors. 2019;91:5-11. doi:10.1016/j.addbeh.2018.10.039