Other tobacco product and electronic cigarette use among homeless cigarette smokers

Abstract

Objective We determined the prevalence and correlates of other tobacco product and electronic cigarette (e-cigarette) use in a clinic-based sample of homeless cigarette smokers. Methods In April-July 2014, we used time-location sampling to conduct a cross-sectional, in-person survey of 306 currently homeless adult cigarette smokers recruited from 5 clinical sites at Boston Health Care for the Homeless Program. We assessed past-month use of large cigars, little cigars, smokeless tobacco, and e-cigarettes. Among those who had used e-cigarettes, we assessed the reasons for doing so. We used logistic regression analysis to identify the participant characteristics associated with the use of each product. Results Eighty-six percent of eligible individuals participated in the survey. In the past month, 37% of respondents used large cigars, 44% used little cigars, 8% used smokeless tobacco, 24% used an e-cigarette, and 68% used any of these products. Reasons for e-cigarette use included curiosity (85%) and to help quit conventional cigarettes (69%). In multivariable regression analyses, homeless smokers with greater subsistence difficulties were more likely to use little cigars (p=0.01) and less likely to use e-cigarettes (p=0.001). Non-Hispanic black (p=0.01), Hispanic (p<0.001), and rough-sleeping (p=0.04) participants were more likely to use large cigars. Readiness to quit was not associated with other tobacco product use but was significantly associated with e-cigarette use to help quit smoking (p=0.02). Conclusions Health care providers who serve homeless people should consider routine screening for the use of other tobacco products and e-cigarettes to help guide smoking cessation discussions and tobacco treatment planning.

Overview of Electronic Nicotine Delivery Systems: A Systematic Review

“…192–194,214,288,325–327,332,335,336,338,353,354,361,369,372,374,382,384,389,390,446,448,449,453–457,461–464,467,471–474,476,477,484,485,488,490,492,493,495,502,503 In the U.S. and Great Britain, this belief has eroded over time with more individuals mistakenly believing ENDS are as harmful or more harmful that cigarettes. 391,414 Studies suggest that ENDS are also perceived as less addictive than cigarettes, 367,375,403,446 tools that may help users reduce or quit smoking, 320,327,330,338,357,374,448,453,455,458,461,464,467,481,483,485,486,488,493,495,499 less expensive than cigarettes, 335,338,447,455,456,472,499 and more convenient or easier to use than cigarettes. 335,338,357,400,499 …”

“…The most commonly cited reasons for use by vapers include: to address tobacco craving/withdrawal symptoms 194,320,353 as reported by 67%–79% of adults 194 and as a smoking-reduction/cessation aid, 192,193,214,241,323,324,326,332,337,338,347,350,353,358,369,372,375,376,381,382,389,393,395,421,422,426,432,434,441,444,456,459,461,463,472,482,502 which was reported by 55%–85% of adults in nationally representative samples 323,350,395 ;to evade smokefree policies or avoid disturbing people with secondhand smoke, 192,193,214,323,324,332,337,338,341,345,347,350,353,358,369,372,374,376,387,389,395,421,426,432,434,441,455,456,461,472,478,502 as reported by 45%–85% of adults in nationally representative samples 323,350,395 ; andbecause they are perceived as less harmful/less toxic than cigarettes 192,194,323,324,326,…”

“…to address tobacco craving/withdrawal symptoms 194,320,353 as reported by 67%–79% of adults 194 and as a smoking-reduction/cessation aid, 192,193,214,241,323,324,326,332,337,338,347,350,353,358,369,372,375,376,381,382,389,393,395,421,422,426,432,434,441,444,456,459,461,463,472,482,502 which was reported by 55%–85% of adults in nationally representative samples 323,350,395 ;…”

“…because they are perceived as less harmful/less toxic than cigarettes 192,194,323,324,326,337,338,341,345–347,350,353,358,372,374,375,382,395,422,434,455,456,459,461,472,502 by 45%–75% of adults in nationally representative samples. 323,350,395 …”

“…Users also report using ENDS because they are less expensive than cigarettes, 145,194,332,337,338,341,350,353,358,372,389,395,455,456,459,472,502 for relapse prevention, 194,353,372 out of curiosity, 341,347,350,358,421,422,432,434,441,444,456,461,476 because they are accessible and convenient, 341,366,387,477 for social reasons, 341,347,363,387,434,444,461,502,504 and because they taste 337,358,426,472,477,496 or smell better than cigarettes. 341,353,389,459,461 Flavors are viewed as an attractive characteristic of ENDS, 345,433 and are a cited reason for vaping.…”