Introduction: Hospitalization can motivate smokers to attempt cessation, and some smokers might use e-cigarettes to aid quitting after discharge. Little is known about the patterns and predictors of smokers' e-cigarette use immediately before, during, and after hospitalization.
Methods: Secondary data analysis of a multi-site randomized controlled trial that enrolled 1357 hospitalized smokers planning to quit offered two intensities of post-discharge cessation treatment and reached 1100 participants at 1-month follow-up. We assessed reasons for and patterns of e-cigarette use before, during and immediately after hospitalization. Multivariable logistic regression models identified independent predictors of e-cigarette use.
Results: E-cigarettes were used, primarily to aid quitting, by 21.4% of smokers in the month before admission, 3.1% during hospitalization, and 18.3% in the month after discharge. At 1 month, 10.6% were past 7-day (current) e-cigarette users, but few used e-cigarettes regularly and 57.3% also smoked tobacco. New e-cigarette use in the month after discharge was rare. The adjusted odds ratio (AOR;95%CI) for current e-cigarette use was higher among smokers who used e-cigarettes before hospitalization (5.08;3.31-7.81), consumed more alcohol (1.80;1.16-2.80) and had less confidence to quit (1.66;1.05-2.61). The AOR was lower among non-Hispanic blacks (0.25;0.09-0.71), Medicaid-insured (0.56;0.33-0.93), and those randomly assigned to receive free cessation medication and counseling at discharge (0.58;0.38-0.90).
Conclusions: Following hospitalization, some smokers who plan to quit use e-cigarettes, particularly if they used them before admission, are less confident to quit, or have less easy access to conventional treatment. Clinicians should document and be prepared to address e-cigarette use among hospitalized smokers.
Keywords: Discharge; Electronic cigarettes; Hospitalization; Patients; Predictors of use; Smoking.
Copyright © 2018. Published by Elsevier Ltd.