Documentation of e-cigarette use and associations with smoking from 2012 to 2015 in an integrated healthcare delivery system

Young-Wolff, Kelly C.; Klebaner, Daniella; Folck, Bruce F.; Tan, Andy S.L.; Fogelberg, Renee; Sarovar, Varada; Prochaska, Judith J.

doi:10.1016/j.ypmed.2018.01.012

Cited by 27 publications

(50 citation statements)

References 39 publications

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“…This research also suggests that dual users are more likely to attain biochemically confirmed abstinence from smoking at 1-year follow-up (8%) than are exclusive smokers (1.9%). This finding agrees with other evidence that dual use is often associated with a greater likelihood of successful cessation (eg, Zhu et al 15 and Young-Wolff et al 39 ). However, this finding must be viewed with caution because of the limitations of this study.…”

Section: Discussionsupporting

confidence: 92%

Changes in Use Patterns Over 1 Year Among Smokers and Dual Users of Combustible and Electronic Cigarettes

Piper

Baker

Benowitz

et al. 2019

Nicotine &Amp; Tobacco Research

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Background Dual use of combustible and electronic cigarettes (e-cigarettes) is a growing use pattern; more than half of e-cigarette users are dual users. However, little is known regarding the course of dual use; for example, the likelihood of discontinuation of either combustible or e-cigarettes or both. Methods Adult daily smokers and dual users (daily smokers who also vaped at least once per week) who did not intend to quit use of either product in the next 30 days participated in a longitudinal, observational study (N = 322, 51.2% women, 62.7% white, mean age = 42.27 [SD = 14.05]). At baseline, participants completed demographics and smoking and vaping history assessments. They also reported daily cigarette and e-cigarette use via timeline follow-back assessment and provided a breath sample for carbon monoxide assay at 4-month intervals for 1 year. Results Of those who completed the year 1 follow-up, 1.9% baseline smokers and 8.0% dual users achieved biochemically confirmed seven-day point-prevalence abstinence from combustible cigarettes (χ2 = 4.57, p = .03). Of initial dual users, by 1 year 43.9% were smoking only, 48.8% continued dual use, 5.9% were vaping only, and 1.4% abstained from both products. Among baseline smokers, 92.3% continued as exclusive smokers. Baseline dual users who continued e-cigarette use were more likely to be white and report higher baseline e-cigarette dependence. Conclusions In this community sample, the majority of dual users transitioned to exclusive smoking. A higher percentage of dual users quit smoking than smokers, but attrition and baseline differences between the groups compromise strong conclusions. Sustained e-cigarette use was related to baseline e-cigarette dependence. Implications This research suggests that dual use of combustible and e-cigarettes is not a sustained pattern for the majority of dual users, but it is more likely to be a continued pattern if the user is more dependent on e-cigarettes. There was evidence that dual users were more likely to quit smoking than exclusive smokers, but this may be due to factors other than their dual use.

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Section: Discussionsupporting

confidence: 92%

Changes in Use Patterns Over 1 Year Among Smokers and Dual Users of Combustible and Electronic Cigarettes

Piper

Baker

Benowitz

et al. 2019

Nicotine &Amp; Tobacco Research

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“…This is a key observation because of concerns that former smokers using e-cigarettes may be more likely to relapse. 23,24 One explanation for the difference in cigarette smoking abstinence among daily and non-daily e-cigarette users may be that these groups differ in their reasons for e-cigarette use, 25 such that cessation may be a less common reason for use among non-daily e-cigarette users. They may be aiming to reduce harm from cigarettes without committing to total abstinence.…”

Section: Discussionmentioning

confidence: 99%

Electronic Cigarette Use and Cigarette Abstinence Over 2 Years Among U.S. Smokers in the Population Assessment of Tobacco and Health Study

Kalkhoran

Chang

Rigotti

2019

Nicotine &Amp; Tobacco Research

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Introduction Electronic cigarettes (e-cigarettes) could benefit public health if they help current smokers to stop smoking long term, but evidence that they do so is limited. We aimed to determine the association between e-cigarette use and subsequent smoking cessation in a nationally representative cohort of US smokers followed for 2 years. Methods We analyzed data from adult cigarette smokers in Waves 1 through 3 of the Population Assessment of Tobacco and Health study. The primary exposure was e-cigarette use at Wave 1. The primary outcome was prolonged cigarette abstinence, defined as past 30-day cigarette abstinence at Waves 2 and 3 (1- and 2-year follow-up). Results Among Wave 1 cigarette smokers, 3.6% were current daily e-cigarette users, 18% were current non-daily e-cigarette users, and 78% reported no current e-cigarette use. In multivariable-adjusted analyses, daily e-cigarette use at Wave 1 was associated with higher odds of prolonged cigarette smoking abstinence at Waves 2 and 3 compared to nonuse of e-cigarettes (11% vs. 6%, adjusted odds ratio [AOR] = 1.77, 95% confidence interval [CI] = 1.08 to 2.89). Non-daily e-cigarette use was not associated with prolonged cigarette smoking abstinence. Among Wave 1 daily e-cigarette users who were abstinent from cigarette smoking at Wave 3, 63% were using e-cigarettes at Wave 3. Conclusions In this longitudinal cohort study of US adult cigarette smokers, daily but not non-daily e-cigarette use was associated with higher odds of prolonged cigarette smoking abstinence over 2 years, compared to no e-cigarette use. Daily use of e-cigarettes may help some smokers to stop smoking combustible cigarettes. Implications In this nationally representative longitudinal cohort study of US adult cigarette smokers, daily e-cigarette use, compared to no e-cigarette use, was associated with a 77% increased odds of prolonged cigarette smoking abstinence over the subsequent 2 years. Regular use of e-cigarettes may help some smokers to stop smoking combustible cigarettes.

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“…For these reasons, it is important for clinicians to accurately ascertain and record e-cigarette use in their patients. However, the current documentation of e-cigarette use in the electronic health records (EHR) is inconsistent [10]. The evidence suggests that many clinicians record e-cigarette information within the "tobacco use" section of the EHR, along with multiple combustible tobacco products (cigarettes, cigars, pipes, etc.…”

Section: Introductionmentioning

confidence: 99%

Improved Documentation of Electronic Cigarette Use in an Electronic Health Record

Jose

Hays

Warner

2020

IJERPH

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The use of electronic cigarettes (e-cigarettes) can affect patient health and clinical care. However, the current documentation of e-cigarette use in the electronic health records (EHR) is inconsistent. This report outlines how the ambulatory clinical practices of a large U.S. hospital system optimized its electronic health records (EHR) framework to better record e-cigarettes used by patients. The new EHR section for e-cigarette information was implemented for outpatient appointments. During a 30-week evaluation period post-implementation, 638,804 patients (12 yrs and older) completed ambulatory appointments within the health system; of these, the new section contained e-cigarette use information for 37,906 (6%) patients. Among these patients, 1005 (2.7%) were identified as current e-cigarette users (current every day or current some day e-cigarette use), 941 (2.5%) were reported as former e-cigarette users, and 35,960 (94%) had never used e-cigarettes. A separate EHR section to document e-cigarette use is feasible within existing clinical practice models. Utilization of the new section was modest in routine clinical practice, indicating the need for more intensive implementation strategies that emphasize the health effects of e-cigarette use, and how consistent ascertainment could improve clinical practice.

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Documentation of e-cigarette use and associations with smoking from 2012 to 2015 in an integrated healthcare delivery system

Cited by 27 publications

References 39 publications

Changes in Use Patterns Over 1 Year Among Smokers and Dual Users of Combustible and Electronic Cigarettes

Changes in Use Patterns Over 1 Year Among Smokers and Dual Users of Combustible and Electronic Cigarettes

Electronic Cigarette Use and Cigarette Abstinence Over 2 Years Among U.S. Smokers in the Population Assessment of Tobacco and Health Study

Improved Documentation of Electronic Cigarette Use in an Electronic Health Record

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