Dataset Information

Prospective association of e-cigarette and cigarette use with alcohol use in two waves of the Population Assessment of Tobacco and Health.

ABSTRACT:

Background and aims

Prior cross-sectional research finds that electronic cigarette (e-cigarette) use clusters with higher rates of harmful alcohol consumption in the United States adult population. The current study examined prospectively the association between e-cigarette use, cigarette use and the combined use of e-cigarettes and tobacco cigarettes and alcohol use outcomes.

Design

A nationally representative multi-wave cohort survey (wave 1: September 2013-December 2014, wave 2: October 2014-October 2015).

Setting

United States.

Participants

A representative sample of civilian, non-institutionalized adults who completed waves 1 and 2 of the Population Assessment of Tobacco and Health survey (n = 26 427).

Measurements

Participants were categorized into exposure groups according to their e-cigarette and cigarette use during wave 1. Past 30-day alcohol use outcomes were (1) National Institute on Alcohol Abuse and Alcoholism (NIAAA)-defined hazardous alcohol use, (2) total alcohol drinks consumed and (3) alcohol-related consequences.

Findings

After controlling for socio-demographic risk factors and alcohol use at wave 1, all exposure groups showed higher odds of hazardous alcohol use [adjusted odds ratios (aORs) = 2.05-2.12, all P < 0.001] and reported higher past-month total drinks (B = 0.46-0.70, all P < 0.001) and more alcohol consequences (B = 0.63-0.89, all P ≤ 0.10) at wave 2 compared with non-users. Cigarette users (B = 0.24, P = 0.038) and dual e-cigarette/cigarette users (B = 0.32, P = 0.038) reported higher past-month total drinks compared with e-cigarette users. There was no conclusive evidence that non-daily use of e-cigarettes or cigarettes predicted poorer alcohol use outcomes compared with daily use.

Conclusions

In the United States between 2013 and 2015, after adjustment for socio-demographic characteristics, cigarette and e-cigarette use were associated with alcohol use 1 year later.

SUBMITTER: Roberts W

PROVIDER: S-EPMC7340560 | biostudies-literature | 2020 Aug

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Prospective association of e-cigarette and cigarette use with alcohol use in two waves of the Population Assessment of Tobacco and Health.

Roberts Walter W Verplaetse Terril T Peltier Mac Kenzie R MKR Moore Kelly E KE Gueorguieva Ralitza R McKee Sherry A SA

Addiction (Abingdon, England) 20200209 8

<h4>Background and aims</h4>Prior cross-sectional research finds that electronic cigarette (e-cigarette) use clusters with higher rates of harmful alcohol consumption in the United States adult population. The current study examined prospectively the association between e-cigarette use, cigarette use and the combined use of e-cigarettes and tobacco cigarettes and alcohol use outcomes.<h4>Design</h4>A nationally representative multi-wave cohort survey (wave 1: September 2013-December 2014, wave 2 ...[more]

PMID: 31977106

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Project description:BackgroundSubstitution of noncombustible tobacco products for cigarettes could improve respiratory symptoms. We hypothesized that complete cigarette-to-e-cigarette switching would improve respiratory symptoms compared to continued smoking.MethodsLongitudinal analysis of data from waves 2-6 (W2-W6; 2014-2021) of the Population Assessment of Tobacco and Health (PATH) Study, an observational cohort study that surveyed 5653 US adults ≥18 years without COPD/chronic bronchitis/emphysema. We compiled 14,947 two-wave (1-2 year) observations with persons who smoked cigarettes at baseline and compared the relation between functionally important respiratory symptoms and switching to exclusive e-cigarette use or quitting tobacco versus continued cigarette use (reference). A 9-point wheezing/nighttime cough index was dichotomized based on index scores of ≥2 or ≥3, previously associated with poorer functional health. Multivariable models assessed how changes in cigarette use predicted worsening/improvement of symptoms.FindingsAmong those with an index score <2, 3.5% switched to e-cigarettes, and 11.1% quit all tobacco. Functionally important respiratory symptoms worsened (≥2 at follow-up) in 15.4%, 10.0% and 10.1% of those who continued cigarettes, switched to e-cigarettes, and quit, respectively. Adjusted relative risk (RR) for respiratory symptom worsening was 0.69 (95% confidence interval (CI), 0.52, 0.91) for e-cigarette switching and 0.73 (95% CI, 0.54, 0.97) for quitting. Of persons with index score ≥2, 2.8% switched to e-cigarettes, and 6.7% quit. Respiratory symptoms improved (<2 at follow-up) in 27.7%, 45.8% and 42.1% of those who continued cigarettes, switched to e-cigarettes, and quit, respectively. The RR for improving was 1.31 (95% CI, 1.05, 1.64) for e-cigarette switching and 1.36 (95% CI, 1.15, 1.62) for quitting. The RRs for exclusive e-cigarette use with a cutoff of ≥3 for respiratory symptom worsening and improvement were not significant (0.74 [0.53, 1.05] and 1.20 [0.95, 1.51] respectively) but were significant in an unweighted analysis that included partial data for individuals lost to follow-up (0.74 [0.57, 0.95] and 1.21 [1.06, 1.39] respectively).InterpretationSwitching completely from past 30-day use of cigarettes to e-cigarettes had short-term beneficial associations with functionally important respiratory symptoms similar to quitting tobacco completely.FundingThis manuscript is supported with Federal funds from the National Institute on Drug Abuse (NIDA) at the National Institutes of Health (NIH), and the Center for Tobacco Products (CTP) at the Food and Drug Administration (FDA), Department of Health and Human Services, under contract to Westat (contract nos. HHSN271201100027C and HHSN271201600001C), and through an interagency agreement between NIH NIDA and FDA CTP. Heather L. Kimmel was substantially involved in the scientific management of and providing scientific expertise for contract nos. HHSN271201100027C and HHSN271201600001C.

Project description:BackgroundWe assessed longitudinal effects of e-cigarette use on respiratory symptoms in a nationally representative sample of US adults by combustible tobacco smoking status.MethodsWe analyzed Waves 4-5 public-use data from the Population Assessment of Tobacco and Health Study. Study sample included adult respondents who reported no diagnosis of respiratory diseases at Wave 4, and completed Waves 4-5 surveys with no missing data on analytic variables (N = 15,291). Outcome was a validated index of functionally important respiratory symptoms based on 7 wheezing/cough questions (range 0-9). An index score of ≥2 was defined as having important respiratory symptoms. Weighted lagged logistic regression models were performed to examine the association between e-cigarette use status at Wave 4 (former/current vs. never use) and important respiratory symptoms at Wave 5 by combustible tobacco smoking status (i.e., never/former/current smokers), adjusting for Wave 4 respiratory symptom index, sociodemographic characteristics, secondhand smoke exposure, body mass index, and chronic disease.ResultsAmong current combustible tobacco smokers, e-cigarette use was associated with increased odds of reporting important respiratory symptoms (former e-cigarette use: adjusted odds ratio [AOR] = 1.39, 95% confidence interval [CI]: 1.07-1.81; current e-cigarette use: AOR = 1.55, 95% CI: 1.17-2.06). Among former combustible tobacco smokers, former e-cigarette use (AOR = 1.51, 95% CI: 1.06-2.15)-but not current e-cigarette use (AOR = 1.59, 95% CI: 0.91-2.78)-was associated with increased odds of important respiratory symptoms. Among never combustible tobacco smokers, no significant association was detected between e-cigarette use and important respiratory symptoms (former e-cigarette use: AOR = 1.62, 95% CI: 0.76-3.46; current e-cigarette use: AOR = 0.82, 95% CI: 0.27-2.56).ConclusionsThe association between e-cigarette use and respiratory symptoms varied by combustible tobacco smoking status. Current combustible tobacco smokers who use e-cigarettes have an elevated risk of respiratory impairments.

Project description:IntroductionThis study examined the association between the current co-use of cannabis and cigarettes in the past 30 days and subsequent cigarette discontinuation (past 30-day point-prevalence abstinence) among U.S. adults with established cigarette use in the Population Assessment of Tobacco and Health (PATH) Study. Additionally, we investigated the impact of co-use on the subsequent discontinuation of all combustible tobacco products.Aims and methodsA total of 26 381 observations contributed by 8218 adults with established cigarette use (ie, smoked ≥100 cigarettes in their lifetime, and currently smoking cigarettes every day or some days) from waves 1-5 of the PATH Study were included in the analysis. Weighted generalized estimating equations (GEE) models were used to evaluate the association between current co-use at baseline (waves 1-4) with the outcomes assessed at the subsequent wave (cigarette and combustible tobacco discontinuation at waves 2-5). Final models included: Demographic characteristics (age, sex, race and ethnicity, and educational attainment), behavior characteristics (intention to quit, internalizing symptoms, externalizing symptoms, and substance use problems), and wave-pair.ResultsOver one-third (35.91%) of the adults currently smoking cigarettes self-reported co-use during the study period. Cannabis use among adults with established cigarette use increased over time. Co-use was associated with decreased odds of cigarette smoking discontinuation at follow-up, after adjusting for covariates (aOR: 0.81; 95% CI: 0.72, 0.93; p = .0018). Similar effect sizes were observed for the discontinuation of all combustible tobacco products (aOR: 0.75; 95% CI: 0.65, 0.86; p < .0001).ConclusionsCannabis use among adults with established cigarette use was inversely related to subsequent cigarette discontinuation, suggesting that co-use may reduce the likelihood of successful tobacco cessation.ImplicationsFindings demonstrate that cannabis use may lead to lower odds of discontinuation among adults with established cigarette use; therefore, individuals who co-use cigarettes and cannabis may need additional tobacco cessation support. Notably, this study observed an increase in the co-use of cigarettes and cannabis, emphasizing the need for researchers and public health programs to shift their focus toward understanding and addressing concurrent substance use among adults who smoke cigarettes.

Project description:ImportanceApproximately 90% of adult smokers first tried a cigarette by 18 years of age, and even infrequent smoking in adolescence is associated with established adult smoking. Noncigarette tobacco use is increasing and could stimulate subsequent conventional cigarette smoking in youths.ObjectiveTo estimate the longitudinal association between noncigarette tobacco use and subsequent cigarette smoking initiation among US youth.Design, setting, and participantsIn this prospective cohort study of the Population Assessment of Tobacco and Health (PATH) waves 1 (September 12, 2013, to December 14, 2014) and 2 (October 23, 2014, to October 30, 2015), a nationally representative sample of youths who never smoked a conventional cigarette at baseline and completed wave 2 follow-up (N = 10 384) was studied. PATH retention at follow-up was 87.9%.ExposuresEver use and past 30-day use of electronic cigarettes (e-cigarettes), hookah, noncigarette combustible tobacco, or smokeless tobacco at baseline.Main outcomes and measuresEver use and past 30-day use of cigarettes at follow-up.ResultsThe present analysis was based on the 10 384 PATH youth respondents who reported never having smoked a cigarette in wave 1 and whose cigarette ever or past 30-day use was reported in wave 2 (mean [SD] age, 14.3 [1.7] years; age range, 12-17 years; 5087 [49.1%] female; 4829 [52.5%] white). At 1-year follow-up, 469 (4.6%) of all baseline never-smoking youths had tried a cigarette and 219 (2.1%) had smoked a cigarette within the past 30 days. Cigarette ever use at follow-up was higher among youths who had ever used e-cigarettes (78 [19.1%]), hookah (60 [18.3%]), noncigarette combustible tobacco (45 [19.2%]), or smokeless tobacco (29 [18.8%]) at baseline. After adjusting for sociodemographic, environmental, and behavioral smoking risk factors and for baseline ever use of other tobacco products, the odds of past 30-day cigarette use at follow-up were approximately twice as high among baseline ever users of e-cigarettes (odds ratio [OR], 1.87; 95% CI, 1.15-3.05), hookah (OR, 1.92; 95% CI, 1.17-3.17), noncigarette combustible tobacco (OR, 1.78; 95% CI, 1.00-3.19), and smokeless tobacco (OR, 2.07; 95% CI, 1.10-3.87). Youths who had tried more than 1 type of tobacco product at baseline had 3.81 (95% CI, 2.22-6.54) greater adjusted odds of past 30-day cigarette smoking at follow-up than did baseline never tobacco users.Conclusions and relevanceAny use of e-cigarettes, hookah, noncigarette combustible tobacco, or smokeless tobacco was independently associated with cigarette smoking 1 year later. Use of more than 1 product increased the odds of progressing to cigarette use.

Project description:IntroductionFirst-order Markov models assume future tobacco use behavior is dependent on current tobacco use and are often used to characterize patterns of tobacco use over time. Higher-order Markov models that assume future behavior is dependent on current and prior tobacco use may better estimate patterns of tobacco use.Aims and methodsThis study compared Markov models of different orders to examine whether incorporating information about tobacco use history improves model estimation of tobacco use and estimated tobacco use transition probabilities. We used data from four waves of the Population Assessment of Tobacco and Health Study. In each Wave, a participant was categorized into one of the following tobacco use states: never smoker, former smoker, menthol cigarette smoker, non-menthol cigarette smoker, or e-cigarette/dual user. We compared first-, second-, and third-order Markov models using multinomial logistic regression and estimated transition probabilities between tobacco use states.`resultsThe third-order model was the best fit for the data. The percentage of former smokers, menthol cigarette smokers, non-menthol cigarette smokers, and e-cigarette/dual users in Wave 3 that remained in the same tobacco use state in Wave 4 ranged from 63.4% to 97.2%, 29.2% to 89.8%, 34.8% to 89.7%, and 20.5% to 80.0%, respectively, dependent on tobacco use history. Individuals who were current tobacco users, but former smokers in the prior two years, were most likely to quit.ConclusionsTransition probabilities between tobacco use states varied widely depending on tobacco use history. Higher-order Markov models improve estimation of tobacco use over time and can inform understanding of trajectories of tobacco use behavior.ImplicationsFindings from this study suggest that transition probabilities between tobacco use states vary widely depending on tobacco use history. Tobacco product users (cigarette or e-cigarette/dual users) who were in the same tobacco use state in the prior two years were least likely to quit. Individuals who were current tobacco users, but former smokers in the prior two years, were most likely to quit. Quitting smoking for at least two years is an important milestone in the process of cessation.

Project description:IntroductionNicotine metabolite ratio (NMR), the ratio of trans 3'-hydroxycotinine to cotinine, is a biomarker of nicotine metabolism. Discrepant findings among clinical trials and population-based studies warrant replication on whether higher NMR, or faster nicotine metabolism, is associated with quitting cigarette smoking. Associations of NMR and e-cigarette use are largely unknown, as well as the relationship between NMR and gender on quitting cigarette smoking or e-cigarette use.MethodsThe Population Assessment of Tobacco and Health (PATH) Study is a nationally representative, longitudinal cohort study assessing tobacco use in the US population. In the current study, the PATH (waves 1 and 2; adult interviews) was used to evaluate longitudinal predictions in relationships among NMR and gender and their association with transitions (quit vs. current stable) in cigarette smoking status and e-cigarette use status across waves 1 and 2 of the PATH study.ResultsNMR and gender were not significantly associated with quit behavior for combustible cigarettes. Regarding e-cigarettes, a significant two-way interaction demonstrated that women with higher NMR were less likely to quit e-cigarette use compared to women with lower NMR (odds ratio [OR] = 0.10, 95% confidence interval [CI] = 0.02-0.57; p = .01).ConclusionsFindings identify that women with faster nicotine metabolism were 10 times less likely to quit e-cigarettes compared to women with slower nicotine metabolism across waves 1 and 2 of the PATH study. Results suggest that NMR may be used as a biomarker for transitions in e-cigarette quit behavior for women.ImplicationsFindings identify that women with faster nicotine metabolism were 10 times less likely to quit e-cigarettes compared to women with slower nicotine metabolism. Results suggest that NMR may be used as a biomarker for transitions in e-cigarette quit behavior for women. Establishing parameters for NMR collection and for the use of NMR as a biomarker for cigarette smoking behavior and e-cigarette use is an important next step, and may have implications for early intervention and treatment for cessation.

Project description:Background and aimsTo estimate progression to polytobacco use (PTU) over 1 year among a sample of US youth.DesignProspective survey with two waves 1 year apart: wave 1 (2013-14) and wave 2 (2014-15). We conducted latent transition analysis (LTA) to identify latent class transitions and examine socio-demographic predictors of transition types.SettingUnited States.ParticipantsA total of 11, 996 people who were aged 12-17 years at wave 1.MeasurementsPublicly available data were used from the Population Assessment of Tobacco and Health (PATH) study, a nationally representative sample of US civilian, non-institutionalized population aged 12 years and older. Tobacco use status was assessed and classified in terms of: never use, non-current (not in the past 30 days) and current (past 30-day) use of cigarettes, cigars, e-cigarettes, hookah and smokeless tobacco. Other nicotine products were excluded because rates of use were either too low to model (e.g. pipe) or the product was not assessed in the PATH youth sample (e.g. nicotine replacement products).FindingsWe identified three distinct patterns: class 1, non-use (wave 1 prevalence = 86%; wave 2 prevalence = 78%); class 2, ever use of cigarettes and e-cigarettes (wave 1 prevalence = 11%; wave 2 prevalence = 14%); and class 3, current PTU (wave 1 prevalence = 4%; wave 2 prevalence = 7%). Probability of progression from non-use to ever use of cigarettes and e-cigarettes was 0.06 and ever use of cigarettes and e-cigarettes to current PTU was 0.32. Non-users were more likely to transition to ever use of cigarettes and e-cigarettes if they were older (versus younger), white (versus non-white) or if their parental education level was high school or less (versus more than high school); and ever users of cigarettes and e-cigarettes to current PTU if they were older, male or white.ConclusionsUS youth who had previously tried e-cigarettes and cigarettes at wave 1 (2013-14) had a 32% chance of transitioning to current use of two or more tobacco products within 1 year.

Dataset Information

Prospective association of e-cigarette and cigarette use with alcohol use in two waves of the Population Assessment of Tobacco and Health.

Background and aims

Design

Setting

Participants

Measurements

Findings

Conclusions

Publications

Prospective association of e-cigarette and cigarette use with alcohol use in two waves of the Population Assessment of Tobacco and Health.

Similar Datasets

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