Emara Nabi-Burza1, Susan Regan1, Bethany Hipple Walters1, Jeremy E Drehmer1, Nancy A Rigotti1, Deborah J Ossip1, Julie A Gorzkowski1, Douglas E Levy1, Jonathan P Winickoff2. 1. Division of General Academic Pediatrics (E Nabi-Burza, BH Walters, JE Drehmer, and JP Winickoff); Massachusetts General Hospital for Children; Tobacco Research and Treatment Center (E Nabi-Burza, S Regan, BH Walters, JE Drehmer, NA Rigotti, DE Levy, and JP Winickoff); Mongan Institute Health Policy Center (NA Rigotti and DE Levy), Massachusetts General Hospital; Harvard Medical School (NA Rigotti, DE Levy, and JP Winickoff) Boston; Department of Public Health Sciences, University of Rochester Medical Center, NY (DJ Ossip); American Academy of Pediatrics, Julius B. Richmond Center of Excellence, Itasca, Ill (JA Gorzkowski and JP Winickoff). 2. Division of General Academic Pediatrics (E Nabi-Burza, BH Walters, JE Drehmer, and JP Winickoff); Massachusetts General Hospital for Children; Tobacco Research and Treatment Center (E Nabi-Burza, S Regan, BH Walters, JE Drehmer, NA Rigotti, DE Levy, and JP Winickoff); Mongan Institute Health Policy Center (NA Rigotti and DE Levy), Massachusetts General Hospital; Harvard Medical School (NA Rigotti, DE Levy, and JP Winickoff) Boston; Department of Public Health Sciences, University of Rochester Medical Center, NY (DJ Ossip); American Academy of Pediatrics, Julius B. Richmond Center of Excellence, Itasca, Ill (JA Gorzkowski and JP Winickoff). Electronic address: jwinickoff@mgh.harvard.edu.
Abstract
BACKGROUND: E-cigarettes are growing in popularity. Dual use of e-cigarettes and cigarettes is an increasingly common practice, but little is known about patterns of dual use in parents. We sought to describe smoking-related behaviors among dual-users. METHODS: Parent exit surveys were conducted following their child's visit in 5 control pediatric practices in 5 states participating in the Clinical Effort Against Secondhand Smoke Exposure trial. We examined factors associated with dual use of e-cigarettes and cigarettes versus cigarette-only smokers, assessed by self-report. RESULTS: Of 1382 smokers or recent quitters screened after their child's visit between April and October 2017, 943 (68%) completed the survey. Of these, 727 parents reported current use of cigarettes; of those, 81 (11.1%) also reported e-cigarette use, meeting the definition of dual use. Compared with cigarette-only smokers, dual users were more likely to have a child younger than 1 year old, planned to quit in the next 6 months, and had tried to quit in the past (had a quit attempt in the past 3 months, called the quitline, or used medicine to quit in the past 2 years; P < .05 for each). CONCLUSIONS: Parents who use both e-cigarettes and cigarettes may have greater rates of contemplating smoking cessation than parents who only smoke cigarettes. These parents may be using e-cigarettes for harm reduction or as a step toward cessation. Identification of these parents may provide an opportunity to deliver effective treatment, including nicotine-replacement therapies that do not expose infants and children to e-cigarette aerosol.
BACKGROUND: E-cigarettes are growing in popularity. Dual use of e-cigarettes and cigarettes is an increasingly common practice, but little is known about patterns of dual use in parents. We sought to describe smoking-related behaviors among dual-users. METHODS: Parent exit surveys were conducted following their child's visit in 5 control pediatric practices in 5 states participating in the Clinical Effort Against Secondhand Smoke Exposure trial. We examined factors associated with dual use of e-cigarettes and cigarettes versus cigarette-only smokers, assessed by self-report. RESULTS: Of 1382 smokers or recent quitters screened after their child's visit between April and October 2017, 943 (68%) completed the survey. Of these, 727 parents reported current use of cigarettes; of those, 81 (11.1%) also reported e-cigarette use, meeting the definition of dual use. Compared with cigarette-only smokers, dual users were more likely to have a child younger than 1 year old, planned to quit in the next 6 months, and had tried to quit in the past (had a quit attempt in the past 3 months, called the quitline, or used medicine to quit in the past 2 years; P < .05 for each). CONCLUSIONS: Parents who use both e-cigarettes and cigarettes may have greater rates of contemplating smoking cessation than parents who only smoke cigarettes. These parents may be using e-cigarettes for harm reduction or as a step toward cessation. Identification of these parents may provide an opportunity to deliver effective treatment, including nicotine-replacement therapies that do not expose infants and children to e-cigarette aerosol.
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