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Is dual use of nicotine products and cigarettes associated with smoking reduction and cessation behaviours? A prospective study in England.
BMJ Open. 2020 03 15; 10(3):e036055.BO

Abstract

OBJECTIVES

To investigate associations of dual use of e-cigarettes and cigarettes with subsequent quitting activity (smoking reduction, quit attempts and use of evidence-based cessation aids). To overcome potential confounding by factors associated with use of pharmacological support, we selected dual use of over-the-counter nicotine replacement therapy (OTC NRT) and cigarettes as a behavioural control.

DESIGN

Prospective cohort study with 6-month follow-up.

SETTING

England, 2014-2016.

PARTICIPANTS

413 current smokers participating in the Smoking Toolkit Study, a representative survey of adults in England, who reported current use of e-cigarettes or OTC NRT and provided data at 6-month follow-up.

MAIN OUTCOME MEASURES

The exposure was dual use of e-cigarettes or OTC NRT at baseline. Outcomes were change in cigarette consumption, quit attempts and use of evidence-based cessation aids during quit attempts over 6-month follow-up. Relevant sociodemographic and smoking characteristics were included as covariates.

RESULTS

After adjustment for covariates, dual e-cigarette users smoked two fewer cigarettes per day at follow-up than at baseline compared with dual OTC NRT users (B=2.01, 95% CI -3.62; -0.39, p=0.015). While dual e-cigarette users had 18% lower odds than dual OTC NRT users to make a quit attempt at follow-up (risk ratio (RR) 0.82, 95% CI 0.67 to 1.00, p=0.049), the groups did not differ in use of cessation aids (RR 1.06, 95% CI 0.93 to 1.21, p=0.388).

CONCLUSIONS

Dual use of e-cigarettes is associated with a greater reduction in cigarette consumption than dual use of OTC NRT. It may discourage a small proportion of users from making a quit attempt compared with dual OTC NRT use but it does not appear to undermine use of evidence-based cessation aids.

Authors+Show Affiliations

Department of Behavioural Science and Health, University College London, London, United Kingdom s.e.jackson@ucl.ac.uk.Department of Behavioural Science and Health, University College London, London, United Kingdom.Department of Behavioural Science and Health, University College London, London, United Kingdom.Department of Behavioural Science and Health, University College London, London, United Kingdom.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

32179563

Citation

Jackson, Sarah E., et al. "Is Dual Use of Nicotine Products and Cigarettes Associated With Smoking Reduction and Cessation Behaviours? a Prospective Study in England." BMJ Open, vol. 10, no. 3, 2020, pp. e036055.
Jackson SE, Farrow E, Brown J, et al. Is dual use of nicotine products and cigarettes associated with smoking reduction and cessation behaviours? A prospective study in England. BMJ Open. 2020;10(3):e036055.
Jackson, S. E., Farrow, E., Brown, J., & Shahab, L. (2020). Is dual use of nicotine products and cigarettes associated with smoking reduction and cessation behaviours? A prospective study in England. BMJ Open, 10(3), e036055. https://doi.org/10.1136/bmjopen-2019-036055
Jackson SE, et al. Is Dual Use of Nicotine Products and Cigarettes Associated With Smoking Reduction and Cessation Behaviours? a Prospective Study in England. BMJ Open. 2020 03 15;10(3):e036055. PubMed PMID: 32179563.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Is dual use of nicotine products and cigarettes associated with smoking reduction and cessation behaviours? A prospective study in England. AU - Jackson,Sarah E, AU - Farrow,Emma, AU - Brown,Jamie, AU - Shahab,Lion, Y1 - 2020/03/15/ PY - 2020/3/18/entrez PY - 2020/3/18/pubmed PY - 2021/2/17/medline KW - cigarette consumption KW - dual use KW - e-cigarettes KW - nicotine replacement therapy KW - smoking cessation SP - e036055 EP - e036055 JF - BMJ open JO - BMJ Open VL - 10 IS - 3 N2 - OBJECTIVES: To investigate associations of dual use of e-cigarettes and cigarettes with subsequent quitting activity (smoking reduction, quit attempts and use of evidence-based cessation aids). To overcome potential confounding by factors associated with use of pharmacological support, we selected dual use of over-the-counter nicotine replacement therapy (OTC NRT) and cigarettes as a behavioural control. DESIGN: Prospective cohort study with 6-month follow-up. SETTING: England, 2014-2016. PARTICIPANTS: 413 current smokers participating in the Smoking Toolkit Study, a representative survey of adults in England, who reported current use of e-cigarettes or OTC NRT and provided data at 6-month follow-up. MAIN OUTCOME MEASURES: The exposure was dual use of e-cigarettes or OTC NRT at baseline. Outcomes were change in cigarette consumption, quit attempts and use of evidence-based cessation aids during quit attempts over 6-month follow-up. Relevant sociodemographic and smoking characteristics were included as covariates. RESULTS: After adjustment for covariates, dual e-cigarette users smoked two fewer cigarettes per day at follow-up than at baseline compared with dual OTC NRT users (B=2.01, 95% CI -3.62; -0.39, p=0.015). While dual e-cigarette users had 18% lower odds than dual OTC NRT users to make a quit attempt at follow-up (risk ratio (RR) 0.82, 95% CI 0.67 to 1.00, p=0.049), the groups did not differ in use of cessation aids (RR 1.06, 95% CI 0.93 to 1.21, p=0.388). CONCLUSIONS: Dual use of e-cigarettes is associated with a greater reduction in cigarette consumption than dual use of OTC NRT. It may discourage a small proportion of users from making a quit attempt compared with dual OTC NRT use but it does not appear to undermine use of evidence-based cessation aids. SN - 2044-6055 UR - https://www.unboundmedicine.com/medline/citation/32179563/Is_dual_use_of_nicotine_products_and_cigarettes_associated_with_smoking_reduction_and_cessation_behaviours_A_prospective_study_in_England_ L2 - https://bmjopen.bmj.com/lookup/pmidlookup?view=long&pmid=32179563 DB - PRIME DP - Unbound Medicine ER -