Article Text
PDF
Abstract
Objectives Approximately 10% (40 000) of US quitline enrollees who smoke cigarettes report current use of electronic nicotine delivery systems (ENDS); however, little is known about callers' ENDS use. Our aim was to describe why and how quitline callers use ENDS, their beliefs about ENDS and the impact of ENDS use on callers' quit processes and use of FDA-approved cessation medications.
Design Qualitative interviews conducted 1-month postregistration. Interviews were recorded, transcribed, double-coded and analysed to identify themes.
Setting Oklahoma Tobacco Helpline.
Participants 40 callers aged ≥18 who were seeking help to quit smoking were using ENDS at registration and completed ≥1 programme calls.
Results At 1-month postregistration interview, 80% of callers had smoked cigarettes in the last 7 days, almost two-thirds were using ENDS, and half were using cessation medications. Nearly all believed ENDS helped them quit or cut down on smoking; however, participants were split on whether they would recommend cessation medications, ENDS or both together for quitting. Confusion and misinformation about potential harms of ENDS and cessation medications were reported. Participants reported using ENDS in potentially adaptive ways (eg, using ENDS to cut down and nicotine replacement therapy to quit, and stepping down nicotine in ENDS to wean off ENDS after quitting) and maladaptive ways (eg, frequent automatic ENDS use, using ENDS in situations they did not previously smoke, cutting down on smoking using ENDS without a schedule or plan to quit), which could impact the likelihood of quitting smoking or continuing ENDS use.
Conclusions These qualitative findings suggest quitline callers who use ENDS experience confusion and misinformation about ENDS and FDA-approved cessation medications. Callers also use ENDS in ways that may not facilitate quitting smoking. Opportunities exist for quitlines to educate ENDS users and help them create a coordinated plan most likely to result in completely quitting combustible tobacco.
- PUBLIC HEALTH
- QUALITATIVE RESEARCH
- smoking cessation
- electronic nicotine delivery systems
- e-cigarettes
- quitlines
This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Statistics from Altmetric.com
Footnotes
Contributors KAV, LAB, GLS and BM contributed to the interview guide and coding methodology. LAB oversaw participant interviews. KAV and BM (with two other coders) coded interviews. KAV led the analysis of coded data, performed the literature review and took primary responsibility for writing the paper. All authors contributed to the conceptualisation of the study, study design, interpretation of data and the preparation of the manuscript. All authors approved the final version of the manuscript.
Funding This project was funded in part by Centers for Disease Control & Prevention Contract #200-2014-M-60619 and the Oklahoma Tobacco Settlement Endowment Trust.
Disclaimer The findings and conclusions in this report are those of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention.
Competing interests All authors have completed the ICMJE uniform disclosure form at http://www.icmje.org/coi_disclosure.pdf and declare: KAV and BM report funding from Centers for Disease Control and Prevention during the conduct of the study and are employees of Optum (formerly Alere Wellbeing, Inc.), the provider of quitline services for participants in this study; LAB reports grants from Oklahoma Tobacco Settlement Endowment Trust during the conduct of the study.
Ethics approval University of Oklahoma Institutional Review Board.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement Data sharing: no additional data are available.