E-Cigarette Flavors and Frequency of E-Cigarette Use among Adult Dual Users Who Attempt to Quit Cigarette Smoking in the United States: Longitudinal Findings from the PATH Study 2015/16–2016/17

Karin A. Kasza, Maciej L. Goniewicz, Kathryn C. Edwards, Michael D. Sawdey, Marushka L. Silveira, Shannon Gravely, Izabella Zandberg, Lisa D. Gardner, Geoffrey T. Fong and Andrew Hyland
Additional contact information
Karin A. Kasza: Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA
Maciej L. Goniewicz: Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA
Kathryn C. Edwards: Behavioral Health & Health Policy Practice, Westat Inc., Rockville, MD 20850, USA
Michael D. Sawdey: Office of Science, Center for Tobacco Products, US Food and Drug Administration, Silver Spring, MD 20993, USA
Marushka L. Silveira: National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD 20852, USA
Shannon Gravely: Department of Psychology, University of Waterloo, Waterloo, ON N2L 3G1, Canada
Izabella Zandberg: Office of Science, Center for Tobacco Products, US Food and Drug Administration, Silver Spring, MD 20993, USA
Lisa D. Gardner: Office of Science, Center for Tobacco Products, US Food and Drug Administration, Silver Spring, MD 20993, USA
Geoffrey T. Fong: Department of Psychology, University of Waterloo, Waterloo, ON N2L 3G1, Canada
Andrew Hyland: Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA

IJERPH, 2021, vol. 18, issue 8, 1-10

Abstract: Potential mechanisms by which e-cigarette use may relate to combustible cigarette smoking cessation are not well-understood. We used U.S. nationally representative data to prospectively evaluate the relationship between e-cigarette flavor use and frequency of e-cigarette use among adult cigarette/e-cigarette dual users who attempted to quit smoking cigarettes. Analyses used Population Assessment of Tobacco and Health (PATH) Study data from adult dual users (2015/16) who attempted to quit smoking between 2015/16 and 2016/17 (Wave 3-Wave 4, n = 685, including those who did/did not quit by 2016/17). E-cigarette flavor use (usual/last flavor, past 30-day flavor; assessed in 2015/16) was categorized into Only tobacco; Only menthol/mint; Only non-tobacco, non-menthol/mint; and Any combination of tobacco, menthol/mint, other flavor(s). The key outcome, evaluated at follow-up in 2016/17, was frequent e-cigarette use, which was defined as use on 20+ of past 30 days. Logistic regression was used to evaluate associations between e-cigarette flavor use in 2015/16 and frequent e-cigarette use at follow-up in 2016/17. Dual users who attempted to quit smoking had greater odds of frequent e-cigarette use at follow-up when they used only non-tobacco, non-menthol/mint flavor than when they used only tobacco flavor as their regular/last e-cigarette flavor (OR = 1.9, 95% CI: 1.1–3.4); findings were no longer significant when adjusted for factors including e-cigarette device type (AOR = 1.4, 95% CI: 0.7–2.8). Past 30-day e-cigarette flavor use results were generally similar, although frequent e-cigarette use at follow-up was highest among those who used any combination of tobacco, menthol/mint, or other flavors. Findings indicate that e-cigarette flavor use among dual users who attempt to quit smoking may be related to e-cigarette use frequency overall, which may indicate a mechanism underlying findings for e-cigarette use and smoking cessation. Further longitudinal research may help to disentangle how e-cigarette characteristics uniquely impact e-cigarette use frequency and smoking cessation/sustained use.

Keywords: e-cigarette flavors; cigarette quit attempt; use frequency; dual use; population; longitudinal; US nationally representative; adults (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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