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

Journal of Cancer Survivorship volume 13, pages 316–325 (2019)Cite this article

Abstract

Purpose

Prior 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.

Methods

Cross-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.

Results

Prevalence 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] = 11.81, 95% confidence interval [CI] = 5.38–25.93). Likewise, former e-cigarette users, compared to never-users, had greater odds of being current combustible cigarette smokers (OR = 15.90, 95% CI = 10.68–23.36).

Conclusion

Among cancer survivors in the USA, e-cigarette use had a positive and highly significant association with combustible cigarette smoking.

Implications for Cancer Survivors

In 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.

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Affiliations

  1. Department of Applied Heath Science, Indiana University School of Public Health, SPH 116, 1025 E 7th Street, Bloomington, IN, 47405, USA

    Godfred O. Antwi, David K. Lohrmann, Angela Chow & Cecilia S. Obeng

  2. Institute for Research on Addictive Behavior, Indiana University School of Public Health, Bloomington, IN, USA

    Wasantha Jayawardene

  3. Department of Epidemiology and Biostatistics, Indiana University School of Public Health, Bloomington, IN, 47405, USA

    Aaron M. Sayegh

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  1. Godfred O. Antwi
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Correspondence to Godfred O. Antwi.

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The Indiana University Institutional Review Board verified the current study as a non-human subject study.

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Antwi, G.O., Lohrmann, D.K., Jayawardene, W. et al. Associations between e-cigarette and combustible cigarette use among U.S. cancer survivors: implications for research and practice. J Cancer Surviv 13, 316–325 (2019). https://doi.org/10.1007/s11764-019-00753-1

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  • DOI: https://doi.org/10.1007/s11764-019-00753-1

Keywords

  • Cancer survivors
  • Electronic cigarettes
  • Combustible cigarettes
  • Nicotine