Electronic cigarette use among patients with cancer: Reasons for use, beliefs, and patient-provider communication

Psychooncology. 2018 Jul;27(7):1757-1764. doi: 10.1002/pon.4721. Epub 2018 Apr 25.


Objective: Smoking tobacco cigarettes after a cancer diagnosis increases risk for several serious adverse outcomes. Thus, patients can significantly benefit from quitting smoking. Electronic cigarettes are an increasingly popular cessation method. Providers routinely ask about combustible cigarette use, yet little is known about use and communication surrounding e-cigarettes among patients with cancer. This study aims to describe patterns, beliefs, and communication with oncology providers about e-cigarette use of patients with cancer.

Methods: Patients with cancer (N = 121) who currently used e-cigarettes were surveyed in a cross-sectional study about their patterns and reasons for use, beliefs, and perceptions of risk for e-cigarettes, combustible cigarettes, and nicotine replacement therapies. Patient perspectives on provider communication regarding e-cigarettes were also assessed.

Results: Most participants identified smoking cessation as the reason for initiating (81%) and continuing (60%) e-cigarette use. However, 51% of patients reported current dual use of combustible cigarettes and e-cigarettes, and most patients reported never having discussed their use of e-cigarettes with their oncology provider (72%). Patients characterized e-cigarettes as less addictive, less expensive, less stigmatizing, and less likely to impact cancer treatment than combustible cigarettes (Ps < .05), and more satisfying, more useful for quitting smoking, and more effective at reducing cancer-related stress than nicotine replacement therapies (Ps < .05).

Conclusions: Patients with cancer who use e-cigarettes have positive attitudes toward these devices and use them to aid in smoking cessation. This study also highlights the need for improved patient-provider communication on the safety and efficacy of e-cigarettes for smoking cessation.

Keywords: cancer; dual use; e-cigarettes; oncology; patient-provider communication; smoking cessation.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Aged
  • Cross-Sectional Studies
  • Electronic Nicotine Delivery Systems* / statistics & numerical data
  • Female
  • Florida / epidemiology
  • Health Communication*
  • Humans
  • Male
  • Middle Aged
  • Neoplasms* / epidemiology
  • Professional-Patient Relations*
  • Smoking Cessation* / statistics & numerical data
  • Smoking* / epidemiology