Study reveals racial and socioeconomic disparities in e-cigarette use for smoking cessation

A new study published in the American Journal of Preventive Medicine highlights the impact of racial and socioeconomic disparities on the use of e-cigarettes as a tool for smoking cessation. The research, led by Boston University School of Public Health and the Keck School of Medicine of the University of Southern California, found that Black, Hispanic, and low-socioeconomic status (SES) smokers were less likely to use e-cigarettes as a tool to quit smoking and more likely to believe e-cigarettes are equally or more harmful than cigarettes.

The study's findings have important implications for public health, as these populations are disproportionately affected by smoking-related diseases and health conditions such as cancer and cardiovascular complications. Policies that reduce vaping are important, but presenting e-cigarettes as more harmful than cigarettes could deter adults who smoke from switching to less harmful forms of nicotine consumption.

Socioeconomic and racial inequities in cigarette and e-cigarette use

The study's authors analyzed data from the US Population Assessment of Tobacco and Health (PATH) Study over five periods between 2013-2019 to examine differences in e-cigarette transitions, as well as beliefs and attitudes about vaping harm, by race/ethnicity, income, and education. They divided these assessments among four categories of smoking/vaping behaviors: exclusive smoking; switching from exclusive smoking to exclusive vaping; dual smoking and vaping; and no smoking or vaping.

The study found that white adults, as well as those with more education and more annual income, were more likely to quit smoking and switch to exclusive e-cigarette use after one year, when compared to Black, Hispanic, and lower-SES adults. Among all people who smoked cigarettes, 69 percent believed that e-cigarettes were equally or more harmful than cigarettes. Hispanic and Black adults were more likely to hold this view of e-cigarette harm, and these perceptions may have contributed to why these populations were less likely to transition from smoking to vaping only.

Importance of communicating risks and benefits of e-cigarettes

The study's authors highlight the potential unintended consequences of regulations and education campaigns focused solely on communicating the risks of e-cigarettes, without also conveying information about their harm relative to cigarettes. Policymakers should consider the impact of e-cigarette regulatory policies on cigarette smoking disparities to promote equitable access to e-cigarettes for cigarette cessation. The researchers say that these sociodemographic differences in cigarette and e-cigarette use underscore the need for anti-smoking and vaping policies to consider additional factors beyond youth vaping dangers and e-cigarette health benefits—such as equitable access to e-cigarettes for smoking cessation.

Journal Information: Alyssa F Harlow et al, Sociodemographic Differences in e-Cigarette Uptake and Perceptions of Harm, American Journal of Preventive Medicine (2023). DOI: 10.1016/j.amepre.2023.03.009