Interactions Between e-Cigarette Use and Quit Intentions on Cigarette Smoking in Lesbian, Gay, Bisexual, Transgender, Queer, and Other Non-Heterosexual or Cisgender Individuals.

introductionAnecdotally, e-cigarette use during a cigarette quit attempt is a common quit strategy, but its efficacy is unclear. This study examined e-cigarette use and setting a daily quit intention on cigarette smoking in lesbian, gay, bisexual, transgender, queer, and other non-heterosexual or cisgender individuals, a population with higher rates of both cigarette and e-cigarette use.

methodsLesbian, gay, bisexual, transgender, queer, and other non-heterosexual or cisgender individuals in California (n = 207, 68% female sex, M[SD] age = 36.3[9.7] years old) completed 35 days of Ecological Momentary Assessments during an unassisted cigarette quit attempt. Each morning, they reported whether they intended to abstain from cigarettes that day (ie, setting a daily quit intention), and each night reported whether they used e-cigarettes and the number of cigarettes smoked that day. Multilevel models tested main effects of current e-cigarette use status and day-level e-cigarette use, as well as interactions with quit intention, on the number of cigarettes smoked.

resultsFifty-nine percent of participants used e-cigarettes during the study. Those who used e-cigarettes smoked significantly fewer cigarettes compared to those with no e-cigarette use (p=.033). Among those who vaped, there was a day-level e-cigarette use $\times$quit intention interaction (p < .001). On days with no quit intention, e-cigarette use was associated with more cigarettes smoked. On days with a quit intention, e-cigarette use that day was associated with fewer cigarettes smoked.

conclusionWhile e-cigarette users overall smoked fewer cigarettes compared to those who do not use e-cigarettes, the effects of day-level e-cigarette use on cigarette smoking depend on an individual's intention to quit that day. e-cigarettes may help smoking cessation, but only if there is an established quit intention. IMPLICATIONS: Within this sample of LGBTQ+ cigarette smokers engaged in an unassisted quit attempt, the effects of e-cigarette use on cigarette smoking depend on intent to quit that day. These results may help explain previous mixed findings in the literature regarding e-cigarette use on smoking cessation.