Use of cessation products, e-cigarettes and cigarette cessation outcomes among adults with substance use problems: Results from 2013-2021 (Waves 1-6) of the Population Assessment of Tobacco and Health (PATH) Study.

Abstract

Aims: The aim of this study was to examine how prior use of cessation products and daily electronic nicotine delivery systems (ENDS) use was related to past-month cigarette abstinence between and within substance use problems (SUPs) categories. Furthermore, we measured past-year use of cessation products and ENDS among people who smoke cigarettes with high and moderate SUPs compared with those without.

Design, setting, participants: Longitudinal study using data from the USA-based Population Assessment of Tobacco and Health (PATH) Study Waves 1-6, collected between 2013/14 and 2021. Data were from adults (ages 18+) who smoked cigarettes in the past-month baseline wave of each wave-pair.

Measurements: The predictor was SUP severity (no/low, moderate and high) as assessed using the Global Appraisal of Individual Needs -Short Screener (GAIN-SS). Outcomes at follow-up were: 1. past-month cigarette abstinence and 2. use of cessation aids [any past-year use of counseling, nicotine replacement therapies (NRTs) and medications] and past-year daily ENDS use. We used generalized estimating equation models (GEE) to examine the relationship between SUP status and the outcomes. All models were weighted and adjusted for age, sex, race/ethnicity and daily cigarette use.

Findings: Our results show no statistically significant differences in the use of counseling, medications and daily ENDS at follow-up between individuals by their SUP status. However, individuals with high SUP severity (vs no/low) had higher odds of past-year use of NRTs [adjusted odds ratio (aOR) = 1.36; 95% confidence interval (CI) = 1.13-1.64]. Furthermore, individuals with high SUPs (aOR = 0.49; 95% CI = 0.37-0.64) had lower odds of past-month cigarette abstinence at follow-up compared with those with no/low severity. Among individuals with high SUP, 2.88%, 9.42%, 5.77% and 5.49% used counseling, NRTs, cessation medications and daily ENDS, respectively.

Conclusion: People with high-severity substance use problems appear to have lower cigarette abstinence than people with low-severity substance use problems, despite no statistically significant differences in the use of most cessation aids.