Association of cigarette and electronic cigarette use patterns with all-cause mortality: a national cohort study of 145,390 US adults
Objective: While e-cigarette use is associated with adverse cardiopulmonary health effects, the mortality risks associated with e-cigarette use alone and combined with smoking remain unexamined. Methods: Data between 2014 and 2018 were obtained from the National Health Interview Survey (NHIS), an an...
| Main Authors: | , , , , , , |
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| Format: | Journal Article |
| Language: | English |
| Published: |
2024
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| Online Access: | https://hdl.handle.net/10356/180052 |
| _version_ | 1826126541743980544 |
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| author | Xie, Wubin Berlowitz, Jonathan B. Raquib, Rafeya Harlow, Alyssa F. Benjamin, Emelia J. Bhatnagar, Aruni Stokes, Andrew C. |
| author2 | Lee Kong Chian School of Medicine (LKCMedicine) |
| author_facet | Lee Kong Chian School of Medicine (LKCMedicine) Xie, Wubin Berlowitz, Jonathan B. Raquib, Rafeya Harlow, Alyssa F. Benjamin, Emelia J. Bhatnagar, Aruni Stokes, Andrew C. |
| author_sort | Xie, Wubin |
| collection | NTU |
| description | Objective: While e-cigarette use is associated with adverse cardiopulmonary health effects, the mortality risks associated with e-cigarette use alone and combined with smoking remain unexamined. Methods: Data between 2014 and 2018 were obtained from the National Health Interview Survey (NHIS), an annual cross-sectional survey of US adults. All-cause mortality and date of death were obtained via linkage of the NHIS to the National Death Index through December 31, 2019. A 6-category composite cigarette (never, former, current) and e-cigarette (current, non-current) exposure variable was created. We examined the association of cigarette and e-cigarette use patterns with all-cause mortality using adjusted Cox models. Results: Among 145,390 participants (79,294 women [51.5%]; 60,560 aged 18–44 [47.4%]), 5220 deaths were observed over a median follow-up of 3.5 years (508,545 total person-years). Dual use of cigarettes and e-cigarettes was associated with higher mortality risk compared with non-current e-cigarette use in combination with never smoking (hazard ratio [HR] 2.44; 95% CI, 1.90–3.13) and had a risk that did not differ from current exclusive smoking (HR, 1.06; 95% CI, 0.83–1.37). Current e-cigarette use in combination with former smoking was associated with a lower mortality risk than current exclusive cigarette smoking (HR 0.64; 95% CI, 0.41−0.99). Conclusions: The addition of e-cigarette use to smoking does not reduce mortality risk compared with exclusive smoking. However, transitioning completely from cigarettes to e-cigarettes may be associated with mortality risk reduction. Further research is needed to verify these findings in larger cohorts and over longer periods of follow-up. |
| first_indexed | 2024-10-01T06:54:21Z |
| format | Journal Article |
| id | ntu-10356/180052 |
| institution | Nanyang Technological University |
| language | English |
| last_indexed | 2024-10-01T06:54:21Z |
| publishDate | 2024 |
| record_format | dspace |
| spelling | ntu-10356/1800522024-09-15T15:38:10Z Association of cigarette and electronic cigarette use patterns with all-cause mortality: a national cohort study of 145,390 US adults Xie, Wubin Berlowitz, Jonathan B. Raquib, Rafeya Harlow, Alyssa F. Benjamin, Emelia J. Bhatnagar, Aruni Stokes, Andrew C. Lee Kong Chian School of Medicine (LKCMedicine) Medicine, Health and Life Sciences E-cigarettes Cigarettes Objective: While e-cigarette use is associated with adverse cardiopulmonary health effects, the mortality risks associated with e-cigarette use alone and combined with smoking remain unexamined. Methods: Data between 2014 and 2018 were obtained from the National Health Interview Survey (NHIS), an annual cross-sectional survey of US adults. All-cause mortality and date of death were obtained via linkage of the NHIS to the National Death Index through December 31, 2019. A 6-category composite cigarette (never, former, current) and e-cigarette (current, non-current) exposure variable was created. We examined the association of cigarette and e-cigarette use patterns with all-cause mortality using adjusted Cox models. Results: Among 145,390 participants (79,294 women [51.5%]; 60,560 aged 18–44 [47.4%]), 5220 deaths were observed over a median follow-up of 3.5 years (508,545 total person-years). Dual use of cigarettes and e-cigarettes was associated with higher mortality risk compared with non-current e-cigarette use in combination with never smoking (hazard ratio [HR] 2.44; 95% CI, 1.90–3.13) and had a risk that did not differ from current exclusive smoking (HR, 1.06; 95% CI, 0.83–1.37). Current e-cigarette use in combination with former smoking was associated with a lower mortality risk than current exclusive cigarette smoking (HR 0.64; 95% CI, 0.41−0.99). Conclusions: The addition of e-cigarette use to smoking does not reduce mortality risk compared with exclusive smoking. However, transitioning completely from cigarettes to e-cigarettes may be associated with mortality risk reduction. Further research is needed to verify these findings in larger cohorts and over longer periods of follow-up. Published version Research reported in this publication was supported by the National Heart, Lung, and Blood Institute of the National Institutes of Health, the National Cancer Institute, and the US Food and Drug Administration's Center for Tobacco Products (grants P50HL120163, 5U54HL120163, U54CA180905, and 1K01HL154130-02). This work was also supported through a Public Policy Award from the American Lung Association and from the National Institute on Drug Abuse (grant K01DA058084). The content is solely the responsibility of the authors and does not necessarily represent the official views of the sponsors. The authors have no conflicts of interest or financial disclosures to disclose. 2024-09-11T02:43:58Z 2024-09-11T02:43:58Z 2024 Journal Article Xie, W., Berlowitz, J. B., Raquib, R., Harlow, A. F., Benjamin, E. J., Bhatnagar, A. & Stokes, A. C. (2024). Association of cigarette and electronic cigarette use patterns with all-cause mortality: a national cohort study of 145,390 US adults. Preventive Medicine, 182, 107943-. https://dx.doi.org/10.1016/j.ypmed.2024.107943 0091-7435 https://hdl.handle.net/10356/180052 10.1016/j.ypmed.2024.107943 38552720 2-s2.0-85189517788 182 107943 en Preventive Medicine © 2024 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/bync-nd/4.0/). application/pdf |
| spellingShingle | Medicine, Health and Life Sciences E-cigarettes Cigarettes Xie, Wubin Berlowitz, Jonathan B. Raquib, Rafeya Harlow, Alyssa F. Benjamin, Emelia J. Bhatnagar, Aruni Stokes, Andrew C. Association of cigarette and electronic cigarette use patterns with all-cause mortality: a national cohort study of 145,390 US adults |
| title | Association of cigarette and electronic cigarette use patterns with all-cause mortality: a national cohort study of 145,390 US adults |
| title_full | Association of cigarette and electronic cigarette use patterns with all-cause mortality: a national cohort study of 145,390 US adults |
| title_fullStr | Association of cigarette and electronic cigarette use patterns with all-cause mortality: a national cohort study of 145,390 US adults |
| title_full_unstemmed | Association of cigarette and electronic cigarette use patterns with all-cause mortality: a national cohort study of 145,390 US adults |
| title_short | Association of cigarette and electronic cigarette use patterns with all-cause mortality: a national cohort study of 145,390 US adults |
| title_sort | association of cigarette and electronic cigarette use patterns with all cause mortality a national cohort study of 145 390 us adults |
| topic | Medicine, Health and Life Sciences E-cigarettes Cigarettes |
| url | https://hdl.handle.net/10356/180052 |
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