Interactions Between E-cigarette Use and Quit Intentions on Cigarette Smoking in LGBTQ+ Individuals

Schuler LA, Kirkpatrick MG, Wang SD, Miner A, Huh J, Pang RD.
Interactions Between E-cigarette Use and Quit Intentions on Cigarette Smoking in LGBTQ+ Individuals
Nicotine Tob Res. 2025 Dec 24:ntaf263. doi: 10.1093/ntr/ntaf263. Epub ahead of print. PMID: 41439571.

Introduction: Anecdotally e-cigarette use during a cigarette quit attempt is a common quit strategy, but its efficacy is unclear. This study examined e-cigarette use and setting a daily quit intention on cigarette smoking in LGBTQ+ individuals, a population with higher rates of both cigarette and e-cigarette use.

Methods: LGBTQ+ individuals in California (n=207, 68% female sex, M(SD) age=36.3(9.7) years old) completed 35 days of Ecological Momentary Assessments during an unassisted cigarette quit attempt. Each morning, they reported whether they intended to abstain from cigarettes that day (i.e., setting a daily quit intention), and each night reported whether they used e-cigarettes, and the number of cigarettes smoked that day. Multilevel models tested main effects of current e-cigarette use status and day-level e-cigarette use, as well as interactions with quit intention, on number of cigarettes smoked.

Results: Fifty-nine percent of participants used e-cigarettes during the study. Those who used e-cigarettes smoked significantly fewer cigarettes compared to those with no e-cigarette use (p=.033). Among those who vaped, there was a day-level e-cigarette use $\times$quit intention interaction (p<.001). On days with no quit intention, e-cigarette use was associated with more cigarettes smoked. On days with a quit intention, e-cigarette use that day was associated with fewer cigarettes smoked.

Conclusion: While e-cigarette users overall smoked fewer cigarettes compared to those who do not use e-cigarettes, the effects of day-level e-cigarette use on cigarette smoking depend on an individual's intention to quit that day. E-cigarettes may help smoking cessation, but only if there is an established quit intention.

Implications: Within this sample of LGBTQ+ cigarette smokers engaged in an unassisted quit attempt, the effects of e-cigarette use on cigarette smoking depend on intent to quit that day. These results may help explain previous mixed findings in the literature regarding e-cigarette use on smoking cessation.