Electronic cigarette use patterns and chronic health conditions among people experiencing homelessness in MN: a statewide survey.

Introduction:
This article reports the results of a survey administered to adults experiencing homelessness in Minnesota in 2015 and 2018. The survey collected data on electronic cigarette (e-cigarette) and combustible cigarette use, potential correlates of e-cigarette use, and self-reported chronic health conditions. The aim of the study was to describe the prevalence and trends in e-cigarette use, correlates of e-cigarettes use, and rates of chronic health conditions by product use pattern in this community-based sample.

Key Points:

* The survey included 3672 adults in 2015 and 4181 adults in 2018.
* The frequency of use increased from 2015 to 2018 for combustible cigarettes (66.9% vs. 72.3%), e-cigarettes (11.4% vs. 14.5%), and dual combustible/e-cigarette use (10.2% vs. 12.9%).
* The strongest bivariate correlates of past 30-day e-cigarette use were younger age, non-binary gender identification, non-heterosexual orientation, identification as White/Caucasian, greater frequency of lifetime homelessness, substance use, lack of regular place for medical care, mental health diagnosis, criminal justice involvement, and combustible cigarette smoking.
* Dual users had significantly higher rates of asthma and cancer than both those using combustible cigarettes and those using neither combustible nor e-cigarettes.

Main Message:
The study found that during a time when cigarette smoking, e-cigarette use, and dual use were decreasing in the general population in Minnesota, rates increased in the homeless population. The rates of dual use were more than five times greater among homeless adults compared to the general population in 2018. The study also identified correlates of e-cigarette use, which can be used to identify subpopulations for intervention targeting. The mechanisms of the relationship between dual use and increased risks of health conditions deserve further study. The findings suggest that continued monitoring and investigation is warranted to understand the role of e-cigarettes in contributing to health disparities among the homeless population.

Leavens ELS, Ford BR, Ojo-Fati O, et al. Electronic cigarette use patterns and chronic health conditions among people experiencing homelessness in MN: a statewide survey. BMC public health. 2020;20(1):1889. doi:10.1186/s12889-020-09919-4