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. 2019 Apr;13(2):316-325.
doi: 10.1007/s11764-019-00753-1. Epub 2019 Apr 6.

Associations between e-cigarette and combustible cigarette use among U.S. cancer survivors: implications for research and practice

Godfred O Antwi  1 , David K Lohrmann  2 , Wasantha Jayawardene  3 , Angela Chow  2 , Cecilia S Obeng  2 , Aaron M Sayegh  4
Affiliations

Associations between e-cigarette and combustible cigarette use among U.S. cancer survivors: implications for research and practice

Godfred O Antwi et al. J Cancer Surviv. 2019 Apr.

Abstract

Purpose: Prior studies established significant associations between e-cigarette use and combustible cigarette smoking in the general population; however, little is known about such associations among cancer survivors. Thus, the current study examined possible associations between e-cigarette use and combustible cigarette smoking among U.S. cancer survivors.

Methods: Cross-sectional data were drawn from the 2016 Behavioral Risk Factor Surveillance System Survey. Binary logistic regression was used to analyze the associations between e-cigarette user status and combustible cigarette-smoking status in a sample of 4680 cancer survivors, controlling for alcohol use and sociodemographic factors. Analyses were weighted for unequal probability of sample selection to reflect national cancer survivor population estimates.

Results: Prevalence for current e-cigarette use and combustible cigarette smoking for cancer survivors was 2.57% and 16.16%, respectively. In the adjusted analyses, cancer survivors who reported current e-cigarette use, compared to never-users, had greater odds of being current combustible cigarette smokers (odds ratio [OR] = 11.81, 95% confidence interval [CI] = 5.38-25.93). Likewise, former e-cigarette users, compared to never-users, had greater odds of being current combustible cigarette smokers (OR = 15.90, 95% CI = 10.68-23.36).

Conclusion: Among cancer survivors in the USA, e-cigarette use had a positive and highly significant association with combustible cigarette smoking.

Implications for cancer survivors: In order to prevent multiple and substitute use of nicotine-delivery products, prevention interventions and cessation programs designed for cancer survivors should specifically target both current combustible cigarette smokers and non-smokers who report former and current e-cigarette use.

Keywords: Cancer survivors; Combustible cigarettes; Electronic cigarettes; Nicotine.

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