Are older adults scheduled for lung cancer screening interested in trying electronic cigarettes when conventional smoking cessation treatment fails? A cross-sectional survey.

INTRODUCTION

Lung cancer screening (LCS) provides an opportunity to offer tobacco cessation treatment, but most people who smoke are unable to quit, even with support. They might benefit from switching to electronic cigarettes (EC), but their perceptions and interest in EC use are unknown.

METHODS

Adults who participated in a smoking cessation clinical trial offered at LCS and still smoked at trial completion were surveyed about their interest in trying EC (primary outcome). Independent variables were EC use history and perceptions of health risks and benefits of EC vs combustible cigarettes (CC). Logistic regression models tested the association of EC use and perceptions with interest in trying EC, adjusting for covariates.

RESULTS

204/359 eligible participants (56.8 %) completed the survey. 56.4 % had never tried EC, and 30.9 % were interested in trying EC in the future. 60.3 % believed EC to be as or more harmful than CC, but 60.8 % thought that EC were likely to help people cut down smoking. Interest in trying EC was positively associated with previous EC experience (OR: 2.08, 95 %CI:1.1-3.9), and the belief that EC were less harmful than CC (OR: 8.9, 95 %CI: 3.2-24.9), or that EC can help people cut down on smoking (OR: 8.6, 95 %CI: 3.5-21.2).

CONCLUSIONS

Adults undergoing LCS who smoke after cessation treatment ends believe that EC can help people cut down, but they overestimate EC health risks. A positive perception of EC is associated with greater interest in trying EC. Education to correct EC misperceptions might increase interest in trying EC as a harm reduction tool among those who smoke.