E-cigarette use and future health of our youth: Results of a community-based cancer needs assessment

Authors: Hillyer GC, Nazareth M, Lima S, Schmitt KM, Reyes A, Albert DA, Bulman WA, Terry MB

Category: Early Detection & Risk Prediction
Conference Year: 2021

Abstract Body:
Although tobacco use is the leading cause of preventable death and disease, 40% of adults in the US are not routinely asked or counseled about their tobacco use during outpatient and primary care visits; fewer are asked about e-cigarette use and other new tobacco products. As part of an assessment of cancer prevention needs in the catchment area of a large New York City cancer center, we gathered information related to cancer screening, social determinants of health, and lifestyle behaviors that included the use of e-cigarettes. Participants included adults diagnosed and/or treated for cancer (n = 563) and patients who received primary care through our ambulatory care network (n = 241) in the past 3 years. Surveys were distributed by email between May and December 2019. Of the 804 surveyed, 11.2% (n = 90) reported having ever used e-cigarettes. E-cigarette use was highest among those 18-39 years (75.6%) compared to 21.1% of those 40-64 years and 3.3% of those ≥65 years (p <0.001) and was also significantly more common among current smokers (55.6% vs. 12.4% former, 7.9% never smokers, p<0.001), those who binge drink alcohol often/very often (32.7% vs. 18.9% never/rarely, p=0.001), have ≥1 smoker in the home (38.5% vs. 8.0% for none, p<0.001) and are LGBTQ+ (23.1% vs. 10.5% heterosexual, p=0.02). After controlling for sociodemographic factors, e-cigarette use was associated with age <40 years (odds ratio [OR] 3.42, 95% confidence interval [CI] 1.78-6.57), current smoking (OR 3.63, 95%CI 1.52-8.68) vs. former or never; often/very often binge drinking (OR 2.98, 95 %CI 1.21-6.02) compared to never/occasional binging; and ≥1 cigarette smoker in the home (OR 4.26, 95%CI 2.29-7.94). Our findings indicate that e-cigarette use is commonly accompanied by frequent binge drinking among young adults and other negative health behaviors and exposures that increase cancer risk. Not only should providers routinely query patients about tobacco use, including the use of e-cigarettes, and alcohol consumption, but this study indicates that Cancer Centers are uniquely positioned to impact future cancer incidence and mortality by educating youth and young adults in the community about the health risks associated with co-use of cigarettes, e-cigarettes and alcohol.

Keywords: E-cigarettes; Tobacco use; Smoking; Youth and young adults; Community survey