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Patterns of E-Cigarette Use Among Primary Care Patients at an Urban Community Center

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Abstract

Tobacco use remains the leading cause of preventable disease and death in the US. The number of tobacco products has grown over the past decade. E-cigarette use has increased rapidly in recent years, but patterns and correlates of use have not been thoroughly assessed. We examined relationships among demographic factors, e-cigarette and conventional cigarette use in a large sample (N = 12,409) of adult patients at a community health center in the Northeastern US. Overall, 13% (N = 1675) of the sample reported ever using e-cigarettes. In logistic regression models, ever having used e-cigarettes was associated with younger age (ages 18–25; OR = 3.5, p < 0.001). Being transgender (OR = 1.8, p < 0.001), bisexual (OR = 1.5, p < 0.001), un-partnered (OR = 1.5, p < 0.001), having a lower income (OR = 1.6, p < 0.001) or a high BMI (OR = 1.4, p = 0.009) were associated with increased odds of use, whereas being a woman (OR = 0.7, p < 0.001) or Black/African American (OR = 0.7, p = 0.007) were associated with lower odds of use. Of the participants who reported e-cigarette use, a majority also endorsed current or former use of conventional cigarettes. Individuals who formerly used conventional cigarettes were nearly three times more likely to report daily e-cigarette use than current users. Among primary care patients at a community health center, e-cigarette use was reported by a sizeable portion of the sample. Overall, odds of use were higher in certain patient populations, and individuals who formally used cigarettes were more likely to report e-cigarette use than individuals who currently smoke, suggesting that e-cigarettes may be functioning as a cessation aid or a strategy to reduce conventional cigarette use.

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Data Availability

The data is owned by a third-party organization (Fenway Health), and the organization’s IRB restricts access to patient data, due to concerns over a risk of inadvertent disclosure of personal health information. Given that the data are abstracted from patients’ primary care medical visits, the preparation of deidentified data is not permitted. Researchers with a reasonable request for a deidentified data set can contact the Fenway Health IRB at regulatory@fenwayhealth.org.

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Psychiatry, Massachusetts General Hospital, One Bowdoin Square, Boston, MA, 02114, USA

    Conall O’Cleirigh, Amelia M. Stanton & Norik Kirakosian

  2. Harvard Medical School, Boston, MA, USA

    Conall O’Cleirigh & Amelia M. Stanton

  3. The Fenway Institute, Fenway Health, Boston, MA, USA

    Conall O’Cleirigh, Dana King, Amelia M. Stanton, Amanda Goldin & Chris Grasso

  4. Division of Allergy & Infectious Diseases, Department of Medicine, University of Washington, Seattle, WA, USA

    Heidi M. Crane

  5. Madison HIV Metabolic Clinic, Harborview Medical Center, Seattle, WA, USA

    Heidi M. Crane

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  1. Conall O’Cleirigh
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Contributions

COC, DK and CG contributed to the study conception, design, and data analysis. The first draft of the manuscript was written by COC, AS, AG and NK. DK, HC and CG critically revised the manuscript. All authors read and approved the final manuscript.

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Correspondence to Conall O’Cleirigh.

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The authors declare they have no financial interests.

Ethical Approval

The Institutional Review Board of Fenway Health approved all study procedures and granted a waiver of informed consent for the current analysis.

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O’Cleirigh, C., King, D., Stanton, A.M. et al. Patterns of E-Cigarette Use Among Primary Care Patients at an Urban Community Center. J Community Health 47, 1–8 (2022). https://doi.org/10.1007/s10900-021-01015-x

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