Use of Electronic Cigarettes in Smoke-Free Spaces by Smokers: Results from the 2014–2015 Population Assessment on Tobacco and Health Study

Abstract

Background: Smoke-free air policies exist to protect users and nonusers from exposure to tobacco smoke. Although electronic nicotine delivery systems (ENDS) may expose passerby to nicotine and particulate matter, few US states regulate indoor use of ENDS. The purpose of this study was to investigate reported rationales for ENDS use and reported ENDS use in public smoke-free places by dual cigarette/ENDS users. Methods: A population of ENDS/cigarette co-users (n = 2051) was drawn from Wave 2 of the Population Assessment of Tobacco and Health (PATH) dataset (2014–2015). Harm reduction beliefs and cessation behavior of co-users were investigated as predictors of ENDS use in public smoke-free places using logistic regression. Results: Fifty-eight percent of dual users reported past 30-day ENDS use in public smoke-free places. Reported use of ENDS to cut down on cigarette smoking (OR: 2.38, 95% CI: 1.86, 3.05), as an alternative to quitting tobacco (OR: 1.71, 95% CI: 1.37, 2.13), or because of belief that ENDS help people to quit cigarettes (OR: 1.52, 95% CI: 1.20, 1.92) were significantly associated with increased odds of ENDS use in smoke-free places. Conclusions: Beliefs that ENDS were useful as cessation tools or posed modified risk to users and nonusers were associated with elevated odds of use ENDS in locations where conventional tobacco is prohibited. Due to limitations in the survey instrument, in-home ENDS use could not be directly assessed in this analysis. However, these self-reported findings suggest that use of ENDS in public places where cigarette use is prohibited is prevalent enough to be of concern for future regulation and enforcement efforts.

Electronic cigarette use among university students aged 18–24 years in New Zealand: results of a 2018 national cross-sectional survey

“…Overall, reported e-cigarette use to cut down on cigarette smoking (OR 2.38, 95% CI 1.86 to 3.05), as an alternative to quitting (OR 1.71, 95% CI 1.37 to 2.13), or because of belief that e-cigarettes help people to quit cigarette smoking (OR 1.52, 95% CI 1.20 to 1.92) were significantly associated with increased odds of vaping in smoke-free places. 57 In our present study, however, it was not clear whether the high prevalence of not vaping in smoke-free spaces was because of existing smoke-free regulations and/or enforcement of any such regulations or whether it was based solely on vapers' own judgement. Further research is needed to monitor patterns of e-cigarette use in smoke-free spaces and the perceptions of non-vapers who share these spaces.…”

“…Non-smokers and younger participants (18-20 years) were more likely to report not vaping in smoke-free spaces than cigarette smokers and older participants, respectively. Using data drawn from Wave 2 of the Population Assessment of Tobacco and Health (PATH) dataset (2014-2015), 57 Dunbar and colleagues found that 54.0% of respondents aged 18-24 years who vaped and smoked cigarettes (ie, dual users) reported vaping in smoke-free spaces. Overall, reported e-cigarette use to cut down on cigarette smoking (OR 2.38, 95% CI 1.86 to 3.05), as an alternative to quitting (OR 1.71, 95% CI 1.37 to 2.13), or because of belief that e-cigarettes help people to quit cigarette smoking (OR 1.52, 95% CI 1.20 to 1.92) were significantly associated with increased odds of vaping in smoke-free places.…”

Use of E-cigarettes and Other Tobacco Products and Progression to Daily Cigarette Smoking

“…In the wave 1 PATH Study survey in 2013-2014, 80% of those who had used an e-cigarette indicated that a reason for use was that they could vape at times when, or in places where, smoking cigarettes was forbidden, 20 and such use 17 is common. 21 Such a secondary role for e-cigarettes may change with the more efficient e-cigarette nicotine delivery systems 17 that became popular in the United States after 2017. 22,23 The PATH Study has numerous strengths.…”

US Nicotine Vaping Product SimSmoke Simulation Model: The Effect of Vaping and Tobacco Control Policies on Smoking Prevalence and Smoking-Attributable Deaths

“…However, the effects of policies targeting cigarettes may be altered by the availability of NVPs. While NVPs may blunt the impact of some cigarette-oriented policies (e.g., use of NVPs in areas that are smoke-free, but not vape-free) [ 105 ], NVPs may instead enhance policy impacts, because smokers may substitute NVPs for cigarettes in response to stricter cigarette-oriented policies. Indeed, demand studies [ 106 , 107 , 108 , 109 ] indicate that NVPs are a substitute for cigarettes, and cessation studies [ 17 , 18 , 19 , 20 , 110 , 111 ] indicate that NVPs are often used by those who have had limited success with traditional cessation treatments.…”