Electronic cigarette use among heart failure patients: Findings from the Population Assessment of Tobacco and Health study (Wave 1: 2013-2014).
Emily C Gathright, Wen-Chih Wu, Lori A J Scott-Sheldon
PMID 31812280WHAT IT FOUND
Adults with heart failure reported e-cigarette use, often alongside cigarettes, and believed e-cigarettes were safer for themselves and people nearby.
Ask about both products when discussing cessation.
Key findings
01Among adults with heart failure, 1% reported current e-cigarette use without cigarette use, 18% reported current cigarette use without e-cigarette use, and 5% reported dual use. Among adults without heart failure, 16.89% reported cigarette use, 1.17% reported e-cigarette use, and 4.36% reported dual use.
02After controlling for age, sex, race, and income, adults with heart failure had higher odds of dual use than adults without heart failure (OR 1.76, 95% CI 1.22 to 2.54), while heart failure status was not associated with cigarette use or e-cigarette use.
03Current dual users with heart failure most often reported that e-cigarettes may be less harmful to nearby people (90%), may be less harmful than cigarettes (85%), are used to help people quit smoking (83%), and can be used where smoking is not allowed (83%).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The analysis was cross-sectional, so it cannot show changes over time or that e-cigarettes caused any outcome. Heart failure status and tobacco product use were self-reported, so recall and reporting errors may affect the estimates. Only 484 adults with heart failure were analysed, and e-cigarette-only users were few, so reasons for use in that group were unstable. The survey asked broad reasons for e-cigarette use and did not ask participants to rank them, so the most important reason is unclear. The findings reflect Wave 1 data collected from September 12, 2013 through December 15, 2014.
Declared interests
The PATH study was sponsored by the National Institutes of Health/National Institute on Drug Abuse and the Food and Drug Administration's Center for Tobacco Products. Westat was contracted to conduct the study and oversaw the study teams, design, and protocol. The authors declared no conflicts of interest.
The easy way to misread this
Do not conclude that e-cigarettes are a safe or effective way for patients with heart failure to stop smoking. This survey reported self-selected use and beliefs; it did not test e-cigarettes or measure cessation outcomes.