Assessment of Formal Tobacco Treatment and Smoking Cessation in Dual Users of Cigarettes and E-cigar
Thursday, August 18, 2022
Posted by: Natalia Gromov
Heiden
BT, Baker TB, Smock N, et al.
Assessment of Formal
Tobacco Treatment and Smoking Cessation in Dual Users of Cigarettes and
E-cigarettes.
[published online ahead of print, 2022 Jul 20]. Thorax.
2022;thoraxjnl-2022-218680. doi:10.1136/thorax-2022-218680
Background. The
utility of electronic cigarettes ('e-cigarettes') as a smoking cessation
adjunct remains unclear. Similarly, it is unclear if formal tobacco treatment
(pharmacotherapy and/or behavioural support) augments smoking cessation in
individuals who use both cigarettes and e-cigarettes.
Methods. We
performed a longitudinal cohort study of adult outpatients evaluated in our
tertiary care medical centre (6/2018-6/2020). E-cigarette use, smoking status
and formal tobacco treatment (deterrent pharmacotherapy and/or behavioural
support) were assessed in 6-month blocks (eg, cohort 1 (C1)=6/2018-12/2018,
C2=1/2019-6/2019 and so on) using our electronic health record. We assessed the
relationship between e-cigarette use (either with or without formal tobacco
treatment) and point prevalence of smoking cessation at 6 and 12 months.
Results. 111
823 unique patients were included in the study. The prevalence of dual use of
cigarettes and e-cigarettes increased significantly over the study period
(C1=0.8%; C2=1.1%; C3=1.8%; C4=2.3%; p<0.001). The prevalence of smoking
cessation at 12 months was higher among e-cigarette users (20.8%) compared with
non-users (16.8%) (risk difference, 4.0% (95% CI 2.5% to 5.5%); adjusted
relative risk (aRR) 1.354, 95% CI 1.252 to 1.464, p<0.0001). Further, among
dual users of cigarettes and e-cigarettes, the prevalence of smoking cessation
at 12 months was higher among individuals who received tobacco treatment
(29.1%) compared with individuals who did not receive tobacco treatment (19.6%)
(risk difference, 9.5% (95% CI, 4.6% to 14.4%); aRR 1.238, 95% CI 1.071 to
1.432, p=0.004).
Interpretation. These
results suggest that dual users of cigarettes and e-cigarettes benefit from
formal tobacco treatment. Clinicians should consider offering formal tobacco
treatment to such patients, though future trials are needed.
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