Introduction This study assessed patterns of e-cigarette and cigarette use from Wave 1 to Wave 2 among adult e-cigarette users at Wave 1 of the Population Assessment of Tobacco and Health (PATH) Study.
Methods We examined changes in e-cigarette use frequency at Wave 2 among adult e-cigarette users at Wave 1 (unweighted n=2835). Adjusted prevalence ratios (aPR) were calculated using a predicted marginal probability approach to assess correlates of e-cigarette discontinuance and smoking abstinence at Wave 2.
Results Half (48.8%) of adult e-cigarette users at Wave 1 discontinued their use of e-cigarettes at Wave 2. Among dual users of e-cigarettes and cigarettes at Wave 1, 44.3% maintained dual use, 43.5% discontinued e-cigarette use and maintained cigarette smoking and 12.1% discontinued cigarette use at Wave 2, either by abstaining from cigarette smoking only (5.1%) or discontinuing both products (7.0%). Among dual users at Wave 1, daily e-cigarette users were more likely than non-daily users to report smoking abstinence at Wave 2 (aPR=1.40, 95% CI 1.02 to 1.91). Using a customisable device (rather than a non-customisable one) was not significantly related to smoking abstinence at Wave 2 (aPR=1.14, 95% CI 0.81 to 1.60).
Conclusions This study suggests that e-cigarette use patterns are highly variable over a 1-year period. This analysis provides the first nationally representative estimates of transitions among US adult e-cigarette users. Future research, including additional waves of the PATH Study, can provide further insight into long-term patterns of e-cigarette use critical to understanding the net population health impact of e-cigarettes in USA.
- electronic nicotine delivery devices
- non-cigarette tobacco products
- surveillance and monitoring
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Contributors BC designed the study and directed its implementation. BR conducted the data analysis, including quality assurance and control. SEJ, AP, JP, CS, KC, GA, MLG, KMC, KAK, MLS, CD, RN, DBA, HLK, NB, WMC and AH contributed to the conceptual design of the study and assisted with drafting of the manuscript (eg, preparing the literature review, identifying key findings and interpretation of study findings in the Discussion section). All coauthors approved the final version of the manuscript prior to submission.
Funding This manuscript is supported with Federal funds from the National Institute on Drug Abuse, National Institutes of Health and the Center for Tobacco Products, Food and Drug Administration, Department of Health and Human Services, under a contract to Westat (Contract No. HHSN271201100027C).
Disclaimer The views and opinions expressed in this manuscript are those of the authors only and do not necessarily represent the views, official policy or position of the US Department of Health and Human Services or any of its affiliated institutions or agencies.
Competing interests MLG receives fees for serving on an advisory board to J&J and grant support from Pfizer. RN served as an expert witness for plaintiff versus tobacco companies. JLP serves as a consultant for plaintiff versus tobacco companies. WMC reports holding stock in General Electric, and 3M Companies and Pfizer. KMC has received grant funding from the Pfizer, Inc., to study the impact of a hospital based tobacco cessation intervention. KMC also receives funding as an expert witness in litigation filed against the tobacco industry. No financial disclosures were reported by the other authors of this paper.
Patient consent Not required.
Ethics approval The study was approved by the Westat Institutional Review Board.
Provenance and peer review Not commissioned; externally peer reviewed.