E-Cigarette Use and Use of Evidence-Based Smoking Cessation Methods Among American Indian Cigarette Smokers: A Cross-Sectional Analysis.

Introduction: Tobacco use is the leading cause of death in the U.S., and American Indian/Alaska Native people have high rates of tobacco-related diseases. Although the U.S. Food and Drug Administration-approved products and evidence-based methods exist for smoking cessation, people who smoke might use E-cigarettes as cessation aids. Whether E-cigarette use is associated with the use of evidence-based methods is unknown, particularly among American Indian/Alaska Native individuals. Methods: Using survey data collected in 2016 from 289 adult American Indian people who smoke and who reported a previous cessation attempt, the authors conducted multivariate logistic regression analyses to assess the associations between E-cigarette use and evidence-based cessation methods. Analyses were performed in 2023. Results: Individuals who currently or formerly used E-cigarettes were significantly more likely to report using nicotine replacement therapy during their last quit attempt than those who did not use E-cigarettes (current versus never AOR=4.6, 95% CI=1.9, 11.9; past versus never AOR=4.6, 95% CI=2.2, 9.8; Conclusions: These results suggest that persons who use E-cigarettes are more likely than individuals who do not use E-cigarettes to previously have tried nicotine replacement therapy but less likely to use the cold turkey method. A larger study is needed to determine whether individuals who use E-cigarettes are also more likely to have tried prescription medication for smoking cessation. Whether E-cigarette use impedes or encourages the use of evidence-based cessation methods is unknown.