Electronic Cigarettes: Are They Smoking Cessation Aids or Health Hazards?

Prevalence and disparities in receiving medical advice to quit tobacco use in the US adult population

Introduction

Evidence suggests that advice from health care professionals (HCP) increases the likelihood of quit attempts and successful quitting of tobacco use. However, previous studies primarily focussed on cigarette smoking and did not include all forms of tobacco products. This study aimed to investigate the prevalence and disparities in receiving HCP's advice to quit tobacco use (combustible or noncombustible) in the US adult population.

Methods

Using the 2022 National Health Information Survey (NHIS) data, we examined 4,424 adults who reported (i) any tobacco product use within the past 12 months and (ii) having seen an HCP within the past 12 months. The outcome variable included the receipt of advice to quit tobacco use from an HCP, and predictors included sociodemographic variables. Weighted prevalence estimates were calculated, and multivariable regression analyses were conducted.

Results

Over 38% of tobacco users who visited an HCP were advised to quit. The odds of receiving such advice were lower among Hispanics (AOR: 0.625; 95% confidence interval (CI) [0.464-0.843];p = 0.002), males (AOR: 0.767; 95% CI [0.659-0.893], p = 0.001), those above the poverty level (AOR: 0.795; 95% CI [0.641-0.987];p = 0.037), foreign-born (AOR: 0.664; 95% CI [0.496-0.888]; p = 0.006), those with a bachelor's degree or higher educational level (AOR: 0.477; 95% CI [0.349-0.653]; p < 0.001) and those aged less than 45 years (AOR: 0.404; 95% CI: [0.344-0.473]; p < 0.001).

Conclusion

The prevalence of receiving HCP's advice to quit tobacco use remains suboptimal and disparate among sociodemographic groups. Our findings call for strategic implementation of the USPHS's recommendation on treating tobacco use and taking further actions to equip HCPs with the training and resources needed to provide appropriate advice to quit tobacco.

Sex and Racial/Ethnic Patterns of Tobacco Product Use Among Students at a U.S. University in 2021-2023

Background: Although the prevalence of conventional tobacco product use among U.S. college students has declined, an increasing number of students use various novel tobacco products. Objectives: This study aims to examine up-to-date sex and racial/ethnic patterns of tobacco use among students at a U.S. university in 2021-2023. Methods: Data of 2,732 students at an urban university in the Southeast of the U.S. were collected in 2021-2023 as part of the National College Health Assessment of the American College Health Association. Self-reported past 3-month use of five tobacco products (cigarette, electronic vapor products, water pipe/hookah, smokeless tobacco, and cigars) was dichotomized. We conducted multinomial logistic regression analysis to examine sex (male or female) and racial/ethnic (non-Hispanic White, non-Hispanic Black, Hispanic, or non-Hispanic Other) differences in single and dual/poly (con-current use of two or more tobacco products) tobacco use compared to nonuse, adjusting for age, student status, parent education level, obese status, psychological distress level, and survey year. Results: Male students had higher odds of being dual/poly tobacco user than female students, adjusting for covariates (adjusted odds ratio [AOR] = 2.00, 95% confidence interval [CI] = 1.42, 2.82). Non-Hispanic Black students had lower odds of being single (AOR = 0.43, 95% CI = 0.26, 0.69) and dual/poly (AOR = 0.09, 95% CI = 0.02, 0.37) tobacco user compared to non-Hispanic White students, adjusting for covariates. Conclusions: Considering higher health risk of con-current use of multiple tobacco products, dual/poly tobacco use prevention strategies targeting male and non-Hispanic White students may be considered.

Adverse Maternal and Infant Outcomes of Women Who Differ in Smoking Status: E-Cigarette and Tobacco Cigarette Users

The electronic cigarette (e-cigarette) became commercially available around 2004, yet the characteristics of pregnant women who use these devices and their effects on maternal and infant health remain largely unknown. This study aimed to investigate maternal characteristics and pregnancy outcomes according to maternal smoking status. We conducted a cross-sectional study of Dutch women with reported pregnancies between February 2019 and May 2022, using an online questionnaire to collect data on smoking status and demographic, lifestyle, pregnancy, and infant characteristics. Smoking status is compared among non-smokers, tobacco cigarette users, e-cigarette users, and dual users (tobacco and e-cigarette). We report descriptive statistics and calculate differences in smoking status between women with the chi-square or Fisher (Freeman-Halton) test. Of the 1937 included women, 88.1% were non-smokers, 10.8% were tobacco cigarette users, 0.5% were e-cigarette users, and 0.6% were dual users. Compared with tobacco users, e-cigarette users more often reported higher education, having a partner, primiparity, and miscarriages. Notably, women who used e-cigarettes more often had small infants for gestational age. Despite including few women in the e-cigarette subgroup, these exploratory results indicate the need for more research to examine the impact of e-cigarettes on pregnancy outcomes.