Associations between electronic cigarette use and quitting behaviours among South African adult smokers. Issue 3 (15th January 2021)

• Record Type: Journal Article
• Authors: Agaku, Israel; Egbe, Catherine O; Ayo-Yusuf, Olalekan
• Is Part Of: Tobacco control. Volume 31:Issue 3(2022)
• Page Start: 464
• Page End: 472
• Publication Date: 2021-01-15
• Subjects: cessation -- electronic nicotine delivery devices -- global health -- low/middle income country -- public policy; Tobacco use -- Prevention -- Periodicals; Tobacco use -- Periodicals; Smoking -- Law and legislation -- Periodicals; Smoking -- prevention & control -- Periodicals; Tobacco Use Disorder -- prevention & control -- Periodicals; Tobacco -- Periodicals; Electronic journals; 613.85
• DOI: 10.1136/tobaccocontrol-2020-056102
• Languages: English
• ISSNs: 0964-4563

Abstract

Abstract : Background: The South African Medicines Control Council classifies e-cigarettes as Schedule 3 substances and requires them to be dispensed only within pharmacies. e-Cigarettes are however ubiquitous and are marketed as cessation aids. We investigated the relationship between e-cigarette use and smoking cessation among South African adult smokers. Methods: Data came from a 2018 web survey of South African adults aged ≥18 years (n=18 208). Cessation-related attitudes and behaviours were assessed. Using multivariable logistic regression, we measured the association between e-cigarette use and cessation behaviours among ever-established combustible tobacco smokers who tried to quit. Findings: Among current combustible smokers, more e-cigarette ever versus never users believed e-cigarettes could assist smokers to completely quit (35.5% vs 20.4%) or cut down (51.7% vs 26.5%) (all p<0.05). Among ever-established smokers, the odds of sustained quitting at the 12-month mark were lower among those who used e-cigarettes once off/rarely (adjusted OR (AOR)=0.20, 95% CI=0.16–0.24), former e-cigarette users (AOR=0.30, 95% CI=0.24–0.38) and current e-cigarette users (AOR=0.23, 95% CI=0.18–0.29), compared with never e-cigarette users. Among ever-established smokers who had ever tried to quit, 53.6% relapsed into smoking after quitting for any length of time. The odds of relapsing among ever-established smokers who had made a quit attempt and had a quit intention were higher among those who used e-cigarettes once off/rarely (AOR=2.66; 95% CI=2.31–3.08), former e-cigarette users (AOR=1.41; 95% CI=1.18–1.69) and current e-cigarette users (AOR=1.85; 95% CI=1.55–2.22) than never e-cigarette users. Conclusion: e-Cigarette use depressed long-term cessation. These findings can inform restrictions on unsubstantiated claims of e-cigarettes as cessation aids within South Africa.