E-cigarettes and Smoking Cessation in Smokers With Chronic Conditions.

Introduction:
This text is a summary of a research study examining the relationship between e-cigarette use and smoking cessation among smokers with and without chronic medical conditions. The study uses data from the Population assessment of Tobacco and health (PaTh) study to determine smoking-cessation behavior and cigarette consumption over time among a cohort of smokers who use e-cigarettes.

Key Points:

* The study analyzes data from Waves 1 and 2 of the PaTh study, which includes a nationally representative sample of U.S. adults and youth.
* The study defines a chronic medical condition as one or more of the following: asthma, cancer, diabetes or prediabetes, stroke, heart attack, bypass surgery, congestive heart failure, or chronic obstructive pulmonary disease.
* The study defines current cigarette smokers as those who report smoking 100 cigarettes in their lifetime and currently smoking every day or some days.
* The primary predictor used in analyses is initiation of e-cigarette use between Waves 1 and 2, defined as current use of e-cigarettes at Wave 2 but not at Wave 1.
* The study assesses two primary outcomes: (1) having tried to quit smoking in the past 12 months at Wave 2 and (2) cigarette abstinence at Wave 2.
* The study controls for demographics, baseline cigarettes per day, and nicotine dependence in multivariable logistic regression models.
* The study finds that e-cigarette use initiation is associated with increased odds of attempting to quit smoking and smoking abstinence at Wave 2, regardless of the presence of a chronic medical condition.

Main Message:
This study suggests that e-cigarette use is associated with increased quitting activity and smoking abstinence among smokers with and without chronic medical conditions. however, further research is needed to assess the safety and efficacy of e-cigarettes as a smoking-cessation or harm reduction strategy for adults with smoking-sensitive disease. Clinicians should continue to encourage smokers to try evidence-based smoking-cessation medications first, but a harm reduction approach involving e-cigarettes may serve as an alternative or complementary strategy for smokers who are not interested in quitting with other modalities or at all.

Kalkhoran S, Chang Y, Rigotti Na. E-cigarettes and Smoking Cessation in Smokers With Chronic Conditions. american journal of preventive medicine. 2019;57(6):786-791. doi:10.1016/j.amepre.2019.08.017