Determining the Effect of Daily Electronic Cigarette Use, Sex, and Cigarettes Smoked at Baseline on the Sum of Average Cigarettes Smoked Per Day Across 3 Measurement Occasions. Público

Abstract

Objective: To quantify change in the sum of average cigarettes smoked per day across 3 measurement occasions using gender, daily electronic cigarette use, and the number of cigarettes smoked at baseline as predictors.

Methods: Secondary analysis of the longitudinal Internet survey conducted from 2011 to 2013 by Professor Jean Francois Etter and Professor Christopher Bullen. Secondary analysis was conducted using SAS 9.3 software's PROC GENMOD procedure. Participants were enrolled on websites dedicated to smoking cessation and electronic cigarette use. We assessed change in cigarettes smoked per day from a sample of n=200 participants.

Results: In Model 1, the Poisson regression model predicting the sum of cigarettes smoked over a 12 month period used baseline cigarettes smoked, sex, and daily e-cigarette usage status as predictors (See Table 2). All predictors were significant in Model 1. When exploring interactions in Model 2, for example, the interaction between daily electronic cigarette usage status and cigarettes smoked per day at baseline as well as the interaction between daily electronic cigarette usage and sex, only the latter interaction was found to be significant (See Table 3: OR=0.772; 95%CI:0.683,0.873; p<.0001). All non-interaction terms remained significant (See Table 3: p<.0001). The interaction between daily electronic cigarette usage status and cigarettes smoked per day at baseline can be interpreted as the "treatment effect" of daily electronic use being dependent on the number of cigarettes smoked at baseline. The interpretation of the interaction between daily electronic cigarette use and sex can be interpreted as the "treatment effect" of daily electronic cigarette use being dependent on sex. Overall, daily electronic cigarette users who were male experienced lower rates of cigarettes smoked per day over 3 measurement occasions when compared to women who did not use electronic cigarettes daily.

Conclusions: Demographic characteristics such as sex, cigarette smoking behavior at baseline, and daily electronic cigarette usage play a role in reducing the sum of average cigarettes smoked per day.

Table of Contents

TABLE OF CONTENTS

Chapter 1: Introduction........................................................................................................1

Problem Statement ............................................................................................................ 3

Purpose Statement................................................................................................................. ..5

Research Hypothesis…………........................................................................................ 6

Significance Statement…………………….......................................................................... 7

Definition of Terms .............................................................................................................. 8

Chapter 2: Literature Review…………….......................................................................... 9

Components and Functionality of the Electronic Cigarette…………….............................. 9

Types of Electronic Cigarettes…………………………………......................................... 10

Variations in Battery Voltage………………………………............................................. 10

Variations in Liquid Concentration……………………………........................................... 10

Differences Between E-cigarettes and Conventional Cigarettes........................................ 14

Primary Mechanistic Difference……………………........................................................ 14

Chemical Content Comparison…..…………………........................................................ 15

Health Impact of Electronic Cigarettes………………........................................................ 17

Awareness, Perception, and Use of Electronic Cigarettes.................................................... 20

Chapter 3: Methods and Materials.................................................................................... 27

Population and Sample Description...................................................................................... 27

Justification....................................................................................................................... 28

Research Design ................................................................................................................... 29

Procedures and Data Analysis............................................................................................... 30

Ethical Considerations........................................................................................................... 33

Chapter 4: Results………………....................................................................................... 34

Descriptive Statistics………………............................................................................. 35

Main Findings: Model 1………………………............................................................. 46

Main Findings: Model 2………………………............................................................. 47

Main Findings: Model 2 Quartile Analysis………......................................................... 49

Chapter 5: Discussion….………………………............................................................. 52

Principal Findings: Literature Review….…………............................................................. 52

Principal Findings: Secondary Analysis….……............................................................. 52

Strengths and Limitations….………………………............................................................. 55

Implications and Recommendations………………............................................................. 57

Future Research and Direction….…………………............................................................. 60

References………………………………………............................................................. 61

About this Master's Thesis

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School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Health Sciences, General
Palavra-chave	ENDS e-cigarette harm reduction electronic nicotine delivery system e-cig electronic cigarette
Committee Chair / Thesis Advisor	Rochat, Roger, Emory University
Partnering Agencies	University, college or educational institution (other than Emory)

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