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. 2019 Jan;28(1):50-59.
doi: 10.1136/tobaccocontrol-2017-054174. Epub 2018 Apr 25.

Transitions in Electronic Cigarette Use Among Adults in the Population Assessment of Tobacco and Health (PATH) Study, Waves 1 and 2 (2013-2015)

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Transitions in Electronic Cigarette Use Among Adults in the Population Assessment of Tobacco and Health (PATH) Study, Waves 1 and 2 (2013-2015)

Blair Coleman et al. Tob Control. .
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Abstract

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.

Keywords: electronic nicotine delivery devices; non-cigarette tobacco products; surveillance and monitoring.

Conflict of interest statement

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.

Figures

Figure 1
Figure 1
Self-reported device type at Wave 21 by Device Type Used at Wave 12 Among All Adult Current E-cigarette Users at Wave 1, PATH Study (N=2,781) 1At Wave 2, “non-customizable” devices were defined as either 1) not rechargeable, not refillable; 2) rechargeable, not refillable, and uses cartridges, or 3) rechargeable, refillable and user cartridges. “Customizable” devices were defined as products that are rechargeable, refillable, use a tank system, and does not use cartridges “Other” was defined as any other combination of device attribute responses 2At Wave 1, “non-customizable” devices were defined as either. 1) not rechargeable, not refillable, 2) rechargeable, not refillable, and uses cartridges, or 3) rechargeable, refillable and uses cartridges “Customizable” devices were defined as a device that is rechargeable, refillable, and does not use cartridges (note use of a tank was not asked at W1) A small number of adult e- cigarette users (n=23) at Wave 1 reported some other combination of device attributes that are not presented in the figure above

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