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Use of Electronic Cigarettes Among U.S. Adults With Medical Comorbidities

  • Gina R. Kruse
    Correspondence
    Address correspondence to: Gina R. Kruse MD, MPH, 50 Staniford Street 9th Floor, Boston MA 02114
    Affiliations
    Division of General Internal Medicine, Tobacco Research and Treatment Center, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts;

    Harvard Medical School, Boston, Massachusetts
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  • Sara Kalkhoran
    Affiliations
    Division of General Internal Medicine, Tobacco Research and Treatment Center, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts;

    Harvard Medical School, Boston, Massachusetts
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  • Nancy A. Rigotti
    Affiliations
    Division of General Internal Medicine, Tobacco Research and Treatment Center, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts;

    Harvard Medical School, Boston, Massachusetts
    Search for articles by this author
Published:January 17, 2017DOI:https://doi.org/10.1016/j.amepre.2016.12.004

      Introduction

      Electronic cigarette (e-cigarette) use is rising in the U.S. Smokers with comorbidities may increasingly use e-cigarettes if they believe e-cigarettes reduce smoking-related harm. This study examined e-cigarette use among adults with medical comorbidities.

      Methods

      In 2016, this study analyzed 68,136 U.S. adults in the 2014 and 2015 National Health Interview Survey. Prevalent e-cigarette use by medical comorbidities and adjusted odds of e-cigarette use were calculated.

      Results

      Among current cigarette smokers, ever use of e-cigarettes was more often reported by adults with one or more medical comorbidity versus those without comorbidity (18–24 years: 73.5% vs 61.4%; 25–44 years: 60.6% vs 54.3%; 45–64 years: 46.5% vs 40.3%; ≥65 years: 35.2% vs 19.4%; all p<0.05). Current smokers aged 25–64 years with one or more comorbidity reported current e-cigarette use more often than those without comorbidity (25–44 years, 17.8% vs 14.3%, p=0.03; 45–64 years, 15.9% vs 11.5%, p=0.02). Current smokers with chronic obstructive pulmonary disease, asthma, and cardiovascular disease had higher odds of ever e-cigarette use versus those without comorbidity. Current smokers with asthma and cardiovascular disease had higher odds of current e-cigarette use. Former smokers with chronic obstructive pulmonary disease had higher odds of ever and current e-cigarette use and former smokers with cancer had lower odds of current e-cigarette use.

      Conclusions

      E-cigarette use by current and former smokers with medical comorbidities is substantial, especially among individuals with chronic lung or cardiovascular disease. Clinicians should routinely ask these patients about e-cigarette use, actively consider all pathways to help their patients quit combustible cigarettes, and recommend evidence-based treatments.
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