Associations between e-cigarette and combustible cigarette use among U.S. cancer survivors: implications for research and practice

Abstract

PurposePrior studies established significant associations between e-cigarette use and combustible cigarette smoking in the general population; however, little is known about such associations among cancer survivors. Thus, the current study examined possible associations between e-cigarette use and combustible cigarette smoking among U.S. cancer survivors.MethodsCross-sectional data were drawn from the 2016 Behavioral Risk Factor Surveillance System Survey. Binary logistic regression was used to analyze the associations between e-cigarette user status and combustible cigarette-smoking status in a sample of 4680 cancer survivors, controlling for alcohol use and sociodemographic factors. Analyses were weighted for unequal probability of sample selection to reflect national cancer survivor population estimates.ResultsPrevalence for current e-cigarette use and combustible cigarette smoking for cancer survivors was 2.57% and 16.16%, respectively. In the adjusted analyses, cancer survivors who reported current e-cigarette use, compared to never-users, had greater odds of being current combustible cigarette smokers (odds ratio [OR]\u2009=\u200911.81, 95% confidence interval [CI]\u2009=\u20095.38–25.93). Likewise, former e-cigarette users, compared to never-users, had greater odds of being current combustible cigarette smokers (OR\u2009=\u200915.90, 95% CI\u2009=\u200910.68–23.36).ConclusionAmong cancer survivors in the USA, e-cigarette use had a positive and highly significant association with combustible cigarette smoking.Implications for Cancer SurvivorsIn order to prevent multiple and substitute use of nicotine-delivery products, prevention interventions and cessation programs designed for cancer survivors should specifically target both current combustible cigarette smokers and non-smokers who report former and current e-cigarette use.