Electronic Cigarette Use and Cigarette-Smoking Cessation attempts among Stroke Survivors in the US.

Introduction:
This text is a research letter presenting the findings of a study examining the association between electronic cigarette (e-cigarette) use and cigarette-smoking cessation attempts among stroke survivors in the US. The study's objective was to estimate the prevalence of e-cigarette use among actively smoking stroke survivors and evaluate its association with at least one cigarette-smoking cessation attempt in the past year. The study's key points highlight its methodology, major findings, and implications for clinical practice.

Key Points:

* The study used cross-sectional analysis of pooled data from the 2016-2018 US Centers for Disease Control and Prevention Behavioral Risk Factor Surveillance System (BRFSS) surveys.
* The study population consisted of respondents who reported a prior stroke and active tobacco cigarettes smoking.
* The study found that the prevalence of active e-cigarette use among stroke survivors was 13.5% (95% CI, 11.8-15.3), and 62.3% (95% CI, 60.2-64.4) reported having attempted to quit smoking within the past year.
* E-cigarette users were more likely to have attempted to quit cigarette smoking in the past year than non-users (73.0% [95% CI, 67.2-78.9] vs 60.7% [95% CI, 58.5-62.9]; odds ratio, 1.63; 95% CI, 1.21-2.19).
* The association between e-cigarette use and cigarette-smoking cessation attempts persisted across various subgroups, including stroke survivors older than 60 years, those living in the Stroke Belt, and those with more smoking-related comorbidities.
* The study's limitations include its cross-sectional observational design and reliance on self-reported data.

Main Message:
The study's findings suggest that e-cigarette use is common among actively smoking stroke survivors and that e-cigarette users are more likely to have attempted to quit cigarette smoking in the past year. Clinicians should be aware of this association and consider inquiring about e-cigarette use as an opportunity to engage patients in smoking cessation. however, patients using e-cigarettes as a smoking cessation aid should be encouraged to use guideline-recommended therapies due to the poorly understood detrimental effects of combustible tobacco and e-cigarette co-use.

Parikh NS, Navi BB, Merkler aE, Kamel h. Electronic Cigarette Use and Cigarette-Smoking Cessation attempts among Stroke Survivors in the US. JaMa neurology. 2021;78(6):759-760. doi:10.1001/jamaneurol.2021.0636