E-cigarette and Traditional Cigarette Use Among Smokers During Hospitalization and 6 Months Later

Use of electronic nicotine delivery systems, most commonly called e-cigarettes (e-cigs,) has been rising over the past few years, with the greatest use among traditional cigarette smokers. The utility and harm of this group of emerging tobacco products are under debate. While some propose them as novel tobacco cessation tools, others decry their potential for sustained addiction and negative health effects. We examined smokers' e-cig use and smoking behaviors at hospitalization and 6 months later. Methods: 979 smokers hospitalized at a tertiary care medical center were recruited to a longitudinal observational study and provided baseline data during hospitalization and 6-months later. Past 30-day (current) e-cig use and smoking rates at both baseline and 6-month follow-up were examined with t-tests. Chi square test examined baseline e-cig use and 6-month smoking status. Results: 823 (84.1%) participants provided data at both time points: mean age was 46 years; 53.6% were White, 44.0% were Black, and 2.5% other; 22.5% had less than a high school degree, 38.8% had a high school diploma/GED, and 38.7% had some college or more; 30.8% were married/domestic partner and 53.6% were male. Current e-cig use was reported by 171 (20.7%) at baseline and 246 (29.9%) at 6-month follow- up, with 98 (11.9%) reporting current e-cig use at both time points. At 6-months follow- up, 12.2% of baseline current e-cig users vs. 13.4% of baseline non-users reported quitting smoking (P = 0.80), with 22% of baseline e-cig users who quit still using e-cigs at 6–months follow-up. Baseline current e-cig users reported higher daily cigarette consumption (14.1 vs. 11.9; P = 0.010) at baseline but not 6-months later (10.3 vs. 9.8; P = 0.619); whereas, continuing smokers with current e-cig use at 6 months follow-up reported fewer cigarettes per day (8.4 vs. 10.5; P = 0.008). Conclusions: Among adult smokers, current e-cig use at hospitalization was associated with higher cigarette consumption at baseline but was not predictive of quitting or consumption (among continuing smokers) at 6-months follow-up. Further, current e-cig use at 6 months was associated with a greater reduction in cigarettes smoked per day among continuing smokers at 6-months after hospitalization.