E-cigarettes and quitting behavior among bar-going young adult smokers in California

Background: Smokeless tobacco products and electronic cigarettes (e-cigarettes) have been promoted to smokers to use in smoke-free environments. Some studies have found that smokers who also use other tobacco products are less motivated to quit than cigarette-only smokers.

Methods: Random time-location samples of young adults attending bars and nightclubs in San Diego, CA completed cross sectional surveys in 2011. Current (past 30-day) smokers' data (n=619) were analyzed to examine the relationship between use of traditional smokeless tobacco, snus, hookah, little cigars and e-cigarettes and reporting having made a quit attempt in the past year.

Results: Forty-three percent of participants were female, mean age was 24 years, and 72.8% were in college/ had graduated college. Participants reflected California's race/ethnic representation with 34% Hispanic, 46% white and 20% other races/ethnicities. Past 30 day use of smokeless tobacco was 6.6%, snus 5.5%, hookah 24.9%, little cigars 12.9% and e-cigarettes 9.9%. Past 30-day use of an e-cigarette was statistically significantly associated with having made a quit attempt in the past year (χ² = 4.049, df=1, p=0.04). Use of any other tobacco product was not statistically significantly associated with having made a past year quit attempt. Having used snus was associated with reporting expecting to be smoking in the next year (χ² = 6.56, df=2, p=0.04).

Discussion: Young adult smokers in this sample tried other tobacco products at disproportionately high rates. Although e-cigarettes have not been approved for smoking cessation, young adult smokers who have tried to quit may be more likely to try them.