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Clients in drug treatment perceive e-cigarettes as lower risk than other tobacco products


Sunday, November 1, 2015

K. Blakely Andrews, BA, Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, CA
Thao Le, MPH, Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, CA
Barbara Tajima, EdM, Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, CA
Joseph Guydish, PhD, MPH, Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, CA
Catherine Henderson, BA, Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, CA
Background: This study compared perceived health risks associated with use of e-cigarettes and other tobacco products among persons enrolled in drug abuse treatment.

Methods:  We recruited a national random sample of 24 drug treatment programs and, in each program, 35-50 clients completed surveys concerning tobacco-related beliefs and behaviors (N = 1,020). Using  percentages, and for each of five tobacco products, respondents rated how likely a user was to: get lung cancer, have trouble catching one’s breath, have a heart attack, or get mouth/lip cancer. All participants were asked about perceived risks of cigarettes, and randomly selected subsets were asked about the perceived risks of each other tobacco product. 

Results: Perceived risk of lung cancer was significantly lower for e-cigarettes (34%) compared to that for combustible cigarettes (60%), cigars (59%), and little filtered cigars (57%). Similarly, perceived risk of heart attack was lower for e-cigarettes (34%) compared to that for combustible cigarettes (58%), cigars (55%), and little filtered cigars (55%). This pattern also held for other perceived risks.  For e-cigarettes compared to smokeless tobacco, risks of mouth cancer (30% v. 68%, p <.0001) and heart attack (34% v. 42%, p <.0001) were seen as higher for smokeless tobacco, while risk of trouble catching one’s breath was seen as higher for e-cigarettes (38% v. 33%, p < .01).

Conclusions: In drug abuse treatment populations where smoking prevalence is known to be high, health-related risks of using e-cigarettes are believed to be significantly lower than those of using all other tobacco products studied except smokeless tobacco.  Increasing experimentation with e-cigarettes, increasing dual use of e-cigarettes with other tobacco products, and increasing use of e-cigarettes only may be expected in the addiction treatment population as a way to reduce tobacco-related health risks.

Learning Areas:

Public health or related laws, regulations, standards, or guidelines
Public health or related public policy
Public health or related research
Social and behavioral sciences

Learning Objectives:
Describe specific health risks which are perceived to be lower for e-cigarettes in comparison with other tobacco products.

Keyword(s): Tobacco Use, Drug Abuse Treatment

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Catherine Henderson is research associate at the University of California, San Francisco and has participated in the development of the survey and the data collection of this current study. She has participated in a number of experimental and intervention studies involving tobacco use and cessation in substance abuse treatment populations.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.