BACKGROUND: The prevalence of e-cigarettes has increased between 2012 and 2014 in Alaska among both current and former smokers. It is unknown whether current smokers who also use e-cigarettes (dual users) are using e-cigarettes to try to quit smoking regular cigarettes, and if they are substituting e-cigarettes for regular cigarettes in places where they cannot smoke.
METHODS: We used three years of data from Alaska Behavioral Risk Factor Surveillance System (BRFSS) to examine these questions among current and former smokers. Analyses were conducted with software that accounted for complex survey design.
RESULTS: Prevalence of e-cigarette use among current and former smokers increased from 7.5% to 21.5% and 0.8% to 6.9% respectively between 2012 and 2014 (p<.01). Further examination of 2 years of data (2013-2014) on e-cigarette use among recent former smokers showed higher use in those who quit in the past year compared to those who had quit between 1 and 5 years before and more than 5 years before (22% compared to 5.2% and 1.8% respectively (p<.01 for both comparisons)). Among current users of both regular cigarettes and e-cigarettes (dual users), 79% reported wanting to quit smoking, compared to 69% of those who smoked regular cigarettes only (p=.048). Among dual users, a total of 42% (95% confidence interval (CI)=32%-51%) reported that they used e-cigarettes to try to quit smoking, and 63% (95% CI=51%-73%) said they used e–cigarettes in places where smoking was not allowed. Patterns of consumption of regular cigarettes were similar among smokers who did and did not use e-cigarettes.
CONCLUSIONS: Dual users and recent quitters of regular cigarettes may be using e-cigarettes to assist them in quit attempts. Dual users reported substituting e-cigarettes, though this was not associated with lower consumption of regular cigarettes in these data. More research is needed to understand use of e-cigarettes among current and former smokers. This information could help inform tobacco control and prevention efforts.