• Sara Kalkhoran, Yuchiao Chang, and Nancy A Rigotti.
• Tobacco Research and Treatment Center, Division of General Internal Medicine, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts. Electronic address: skalkhoran@mgh.harvard.edu.
• Am J Prev Med. 2019 Dec 1; 57 (6): 786-791.

IntroductionMany smokers with chronic medical conditions use e-cigarettes. This study assessed the association between e-cigarette use and subsequent smoking-cessation efforts in adult smokers with and without chronic medical conditions.MethodsThis was a longitudinal cohort study of adult cigarette smokers using Waves 1 and 2 of the Population Assessment of Tobacco and Health Study (2013-2015), analyzed in 2018‒2019. The exposure was the initiation of e-cigarette use by Wave 2. The outcomes at Wave 2 were: (1) past 12-month attempts to quit, (2) cigarette abstinence, (3) ≥50% reduction in cigarette use, and (4) past 12-month use of evidence-based smoking-cessation treatment.ResultsE-cigarette use initiation was associated with increased odds of attempting to quit smoking at Wave 2 among smokers with any chronic medical condition (AOR=1.92, 95% CI=1.42, 2.59) and without chronic medical conditions (AOR=1.81, 95% CI=1.50, 2.18). E-cigarette use initiation was also significantly associated with Wave 2 smoking abstinence in smokers with (AOR=1.95, 95% CI=1.11, 3.43) and without chronic medical conditions (AOR=1.63, 95% CI=1.17, 2.28).ConclusionsAt a population level, e-cigarette use by smokers with chronic medical conditions is associated with more quitting activity and smoking abstinence. Future studies are needed to assess e-cigarette safety and efficacy to determine whether they may provide an alternative smoking-cessation or harm-reduction strategy for adults with smoking-sensitive disease who cannot achieve these goals with other methods.Copyright © 2019 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

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