Main and Interactive Effects of Nicotine Product Type on Sleep Health Among Dual Combustible and E‐Cigarette Users

Abstract

Background and Objectives E‐cigarette use is associated with concurrent use of combustible cigarettes among adults and may increase the risk of future combustible cigarette use in adolescents and young adults. Detrimental effects of combustible cigarette use on sleep health are well documented, but little is known about the additive effects of concurrent e‐cigarette use. The current study examined the main and interactive effects of daily nicotine product frequency on various components of sleep health. Methods Two hundred and twenty‐seven dual‐product users (54.2% female, Mage = 36.89, SD = 10.17) completed questionnaires regarding demographic information, average number of cigarettes smoked per day, average number of times e‐cigarettes used per day, and sleep health. Results Combustible cigarette frequency uniquely predicted shorter sleep duration, whereas e‐cigarette frequency uniquely predicted increased daytime dysfunction due to sleepiness. Further, there was an interactive effect of combustible and electronic cigarettes on the use of sleeping medications. Discussion and Conclusions Findings may suggest differential adverse effects on sleep, depending on the type of nicotine product used, and highlight potential intervention targets for users. Future work should examine these associations prospectively and/or use objective measurements of sleep and nicotine use to further elucidate the nature of these relationships. Scientific Significance This is the first study to explore the main and interactive effects of dual‐product use on various dimensions of subjective sleep quality. This is important to investigate, given that dual nicotine users are at greater risk for physical health problems as well as the adverse effects of nicotine on sleep health. (Am J Addict 2020;00:00–00)

Dual use of e-cigarettes with conventional tobacco is associated with increased sleep latency in cross-sectional Study

“…For example, while Brett et al found that e-cigarette use worsened sleep quality in young adults, the study excluded dual users 38 . There are two studies that sought to address the impact of dual usage on sleep health; however, each had limitations such as they either focused on specific age groups, assessed only one type of inhalant use, or used generic questions (non-validated questionnaires) for evaluating sleep 39 , 40 . Moreover, the articles also concluded that further investigation was required to properly assess the impact of e-cigarette or dual usage on sleep.…”

Deleterious Association of Inhalant Use on Sleep Quality during the COVID-19 Pandemic

“…Only one study did not find a difference in sleep duration or quality in e-cigarette users; however, this study design had concerning limitations using unvalidated methods for assessing sleep [5]. The remaining nine articles had findings supportive of a relationship between e-cigarette use and decreased sleep quality including sleep duration, onset, latency or regularity [6][7][8][9][10][11][12][13][14]. In summary, although the articles all had unique limitations from study design to generalizability of findings, the vast majority of the articles concluded that e-cigarette or dual use leads to alterations in sleep that need further investigation.…”