Introduction
Primary care visits present an opportune time to assess behaviors that contribute
to patient health. Smoking, alcohol use, and illicit drugs are routinely documented
in electronic health records, but less is known about screening for E-cigarette use
and the prevalence of E-cigarette use in primary care settings.
Methods
Data include 134,931 adult patients who visited 1 of 41 primary care clinics within
a 12-month period (June 1, 2021–June 1, 2022). Data on demographics, combustible tobacco,
alcohol, illicit drug, and E-cigarette use were extracted from electronic medical
records. Logistic regression was utilized to examine the variables associated with
differential odds of being screened for E-cigarette use.
Results
Rates of E-cigarette screening (n=46,997; 34.8%) were significantly lower than that of tobacco (n=134,196; 99.5%), alcohol (n=129,766; 96.2%), and illicit drug (n=129,766; 92.6%) use. Of those assessed for E-cigarette use, 3.6% (n=1,669) reported current use. Of those with documented nicotine use (n=7,032), 17.2% (n=1,207) used mono E-cigarettes exclusively, 76.3% (n=5,364) used combustible tobacco exclusively, and 6.6% (n=461) reported dual use (both E-cigarette use and combustible tobacco use). Those
who used combustible tobacco or illicit substances as well as younger patients were
more likely to have been screened for E-cigarette use.
Conclusions
Overall rates of E-cigarette screening were significantly lower than those of other
substances. The use of combustible tobacco or illicit substances was associated with
an increased likelihood of being screened. This finding may be because of the relatively
recent proliferation of E-cigarettes, the recent addition of E-cigarette documentation
to the electronic health record, or a lack of training on screening for E-cigarette
use.
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Article info
Publication history
Published online: March 03, 2023
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© 2023 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
