Presentations

Abstract

Introduction:

While the causal link between cigarette smoking and cancer risk is well-established, research on e-cigarette use and cancer is in its infancy. This study assessed e-cigarette and cigarette use among cancer survivors and how it differs from the general population.

Methods:

Data came from 29,482 US adults who participated in the 2021 National Health Interview Survey. Weighted multivariable logistic regression was performed to examine the patterns of tobacco use by cancer status accounting for confounders including age, race, education, sex, sexual orientation, and income. Adjusted odds ratios (AORs) with 95% confidence intervals (CI) were reported. Tobacco products use patterns were reported as never, former (used in the past but not now), and current (use some days or every day)

Results:

In 2021, 9.8% (estimated 25 million) of the US population were cancer survivors. Overall, 18.3% of reported cancers were smoking-related (e.g., lung cancer). Compared to the general population, cancer survivors were more likely to be former users of e-cigarettes (AOR=1.28: 95% CI:1.07-1.52,p-0.006) and cigarette (AOR=1.33:95%CI:1.21-1.47,p<.0001). No significant difference was observed in the current use of these products. Nevertheless, cancer survivors with smoking-related cancers (vs. non-smoking-related) were more likely to be current (AOR:2.3;95%CI:1.55-3.41:p<.0001) and former cigarette smokers (AOR=1.61: 95% CI:1.25-2.07,p-0.0002). They also had higher odds of being current e-cigarette users (AOR; 2.19; 0.88-5.45;p=0.09) than non-smoking-related cancer survivors.

Conclusion:

The high rates of former smoking among cancer survivors highlights the need for continued support for cessation, even after a diagnosis. Relapse prevention interventions should target cancer survivors. In addition, smoking cessation interventions should be integrated into cancer care, especially for patients with smoking-related cancers where continued tobacco use can adversely impact outcomes. Further research on e-cigarette use among cancer survivors is warranted given potential risks/benefits for this population, considering long-term studies on efficacy and safety of these products.