E-cigarette Characteristics and Cigarette Smoking Cessation Behaviors Among U.S. Adult Dual Users of Cigarettes and E-cigarettes

It is critical to understand determinants of cigarette smoking cessation in the current tobacco product landscape. This study assesses the roles of e-cigarette flavoring, device type, and use frequency on cigarette smoking cessation behaviors among US adult dual users of cigarettes and e-cigarettes. We analyzed a sample of 1,038 adult dual users of cigarettes and e-cigarettes from the 2018-2019 Tobacco Use Supplement-Current Population Survey. We defined three smoking cessation behavior stages in current smokers: pre-contemplation, contemplation, and preparation to quit smoking. Multinomial regression models (reference group ) regressed smoking cessation behavior stages on e-cigarette flavoring, device type, and use frequency, adjusting for sociodemographic and cigarette characteristic covariates. Dual users who used e-cigarettes with a replaceable cartridge (Adjusted Odds Ratio (AOR) 1.69, 95% CI 1.03-2.44) or tank e-cigarettes (AOR 2.03, CI 1.20-3.44) had greater odds of being in the contemplation (vs. pre-contemplation) smoking cessation stage than adults who used disposable e-cigarettes. Dual users who used e-cigarettes between 10 and 24 days in the past month had greater odds of being in the contemplation (vs. pre-contemplation) smoking cessation stage (AOR 1.79, CI 1.20-2.69), while adults who used e-cigarettes 25 + days had greater odds of being in the preparation (vs. pre-contemplation) stage (AOR 3.00, CI 1.87-4.82) compared to those who used e-cigarettes 1-9 days in the past month. Our findings suggest that the type of e-cigarette and the frequency of e-cigarette use affect smoking cessation behaviors among adult dual users of cigarettes and e-cigarettes.