The aim of this study was to evaluate socioeconomic and racial/ethnic differences in e-cigarette uptake and harm perceptions about e-cigarettes among adults who smoke cigarettes in the United States (US).
Five waves of the US Population Assessment of Tobacco and Health (PATH) Study (2013-2019) were used to assess transitions from exclusive cigarette smoking to  exclusive e-cigarette use  dual use  nonuse of either product (N=7,172). Analyses (conducted in 2022) estimated differences in transitions and e-cigarette harm perceptions by race/ethnicity, income, and education.
Hispanic (OR=0.32, 95%CI: 0.18-0.54) and Black (OR=0.38, 95%CI: 0.22-0.65) adults were less likely than White adults to transition from exclusive cigarette to exclusive e-cigarette use after one year. Adults with a Bachelor's degree (versus less than high school, OR=2.57, 95%CI: 1.49-4.45) and adults making ≥$100,000/year (versus <$10,000, OR=3.61, 95%CI: 2.10-6.22) were more likely to transition from exclusive cigarette to exclusive e-cigarette use. Hispanic and Black adults and those with lower income and education were more likely to perceive e-cigarettes as equally or more harmful than cigarettes, which in turn was associated with lower odds of transitioning from exclusive cigarette smoking to exclusive e-cigarette use (OR=0.62, 95%CI: 0.47-0.81) .
Adults who were Hispanic, Black, and/or had lower socioeconomic status were less likely to use e-cigarettes to quit cigarettes. Findings provide preliminary evidence that differences in harm perceptions may contribute to disparities in e-cigarette transitions.
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