Socio-demographic disparities in e-cigarettes and cigarette use among adults with epilepsy in the United States, findings from the 2021 National Health Interview Survey
Abstract
Introduction:
Smoking cigarettes among US adults has declined since the mid-1960s, however, disparities persist; declines have not been consistent across some populations including epileptic adults. This study examined socio-demographic disparities in e-cigarettes and cigarette use among people living with epilepsy (PLWE).
Methods:
Data were drawn from the 2021 National Health Interview Survey (NHIS). Our analytic sample included 511 PLWE (extrapolated 4.5 million US PLWE) who participated in 2021 NHIS. We performed weighted multivariable regression models to explore the sociodemographic disparities in current use (i.e., use on every or some days) of e-cigarettes and cigarettes. All analyses were weighted to adjust for non-response and to be representative of PLWE in the US. Adjusted odds ratios(AORs) and 95% confidence intervals(CI) are reported.
Results:
Compared to non-smokers, current smokers were more likely to be male (AOR=1.4; 95%CI:1.2-1.5), in older age groups (vs 18-24, AOR range=2.1-5.1), less educated (vs. graduate degree, AOR range=2.3-5.8), and live beneath the poverty threshold (vs above, AOR range=1.8-2.3) (all ps<0.0001). They were less likely to be non-white (vs. white, AOR range=0.3-0.6) and have health insurance (vs. none, AOR=0.6; 95%CI: 0.5-0.7)(all ps<0.0001).
Compared to PLWE who were non-users of e-cigarettes, current users were more likely to be male (AOR=1.5; 95%CI:1.4-1.7), gay, lesbian, or bisexual (vs straight, AOR=2.1; 95%CI:1.6-2.7), less educated (vs graduate degree AOR range=1.7-2.8, all p<0.0001), and live beneath the poverty threshold (vs. above, AOR= 1.2; all ps<0.05). They were less likely to be older in age (vs 18-24, AOR range=0.1- 0.5), non-white (vs. white, AOR range=0.4-0.7) and have health insurance (vs. none, AOR=0.8, 95%CI0.7-1.0; p<0.05).
Conclusions:
Sociodemographic disparities exist in e-cigarette and cigarette use among US PLWE. This reflects the uneven distribution of tailored cessation interventions among this vulnerable population. Therefore, it is crucial to design, develop, and implement tobacco cessation preventive measures to address the needs of PLWE.