Dual use of electronic cigarettes and tobacco in New Zealand from a nationally representative sample

Abstract

Objective: There is strong interest in the use of electronic cigarettes (e‐cigarettes) globally. Not much is known about the dual use of e‐cigarettes and combustible tobacco cigarettes, or if there are demographic differences among dual users and e‐cigarette only users. This paper reports on the demographics of dual users and e‐cigarette only users in New Zealand in a nationally representative sample. Methods: The Health and Lifestyles Survey (HLS) is a biennial face‐to‐face in‐house survey of New Zealand adults aged 15 years or over. The HLS was completed by 3,854 participants in 2016. Results: There is clear evidence of significant dual use in the current sample: most current e‐cigarette users (63.9%) were dual users. Respondents 45 years and older were twice as likely to be dual users as those aged 15 to 34 years. Conclusion: The current study found evidence for substantial dual use of e‐cigarettes and combustible tobacco cigarettes among adult e‐cigarette users, particularly among users aged 45 years and over. Implications for public health: Public health initiatives should provide clear advice that e‐cigarettes should be used as a smoking cessation tool and not as a way to allow the consumption of combustible tobacco to continue.

Association between dual use of e-cigarette and cigarette and chronic obstructive pulmonary disease: an analysis of a nationwide representative sample from 2013 to 2018

“…The estimate of the prevalence of current e-cigarette use from the Behavioral Risk Factor Surveillance System in 2016 was 4.5% [ 31 ]. The overall percentage of dual users in our study was 1.3%, which was slightly lower than that in previous studies from the United States (1.8% to 2.0%) [ 20 , 31 ] and New Zealand (2.7%) [ 12 ]. Importantly, among current e-cigarette users, 84.6% used e-cigarette and c-cigarette concurrently in the present study, and the rate of concurrent use was comparable with the rates reported in other countries: 74% in Germany [ 13 ], 83% in France [ 15 ], 65% in New Zealand [ 12 ], and 76% in Japan [ 14 ].…”

“…The overall percentage of dual users in our study was 1.3%, which was slightly lower than that in previous studies from the United States (1.8% to 2.0%) [ 20 , 31 ] and New Zealand (2.7%) [ 12 ]. Importantly, among current e-cigarette users, 84.6% used e-cigarette and c-cigarette concurrently in the present study, and the rate of concurrent use was comparable with the rates reported in other countries: 74% in Germany [ 13 ], 83% in France [ 15 ], 65% in New Zealand [ 12 ], and 76% in Japan [ 14 ]. Considering that most e-cigarette users also use c-cigarette, it is challenging to determine the independent effect of e-cigarette on the risk of COPD.…”

“…The difficulties associated with evaluating the effects of e-cigarettes on the risk of COPD have been reported in previous studies. First, because most e-cigarette users concurrently smoked c-cigarettes [ 12 – 15 ], comparing the association between e-cigarettes and COPD according to smoking status could be challenging. Although several biochemical methods using urine samples, such as cotinine and 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) have been introduced, limited progress has been made in the effort to differentiate e-cigarette users from cigarette users [ 16 – 18 ].…”

Comparison of e‐cigarette use characteristics between exclusive e‐cigarette users and dual e‐cigarette and conventional cigarette users: an on‐line survey in France

“…In 2016, 58.8% of vapers were dual users in France and 63.9% in New Zealand , a prevalence similar to that observed in the United States in 2015 (59%) . According to recent data, dual use comprises 44% of vapers in the United Kingdom .…”

Systematic review and meta-analysis of evidence on the efficacy of e-cigarette use for sustained smoking and nicotine cessation

“…[40][41][42][43] At the same time, use of ENDS may potentially support continuing smoking and dual use of combustible tobacco cigarettes and e-cigarettes is one of the most common patterns of observed use. [44][45][46] High cost, limitations on places where smoking is allowed, bans on advertising, clear health warnings and reduced social acceptability are all important elements in comprehensive tobacco control. 47 Smokers may potentially be able to mitigate some of these impacts through dual use with ENDS, thereby prolonging smoking, as ENDS are generally cheaper than smoking, are often able to be used in settings where combustible cigarettes are prohibited, their health impacts are less clear and they are often more socially acceptable.…”