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A Descriptive Analysis of Transitions from Smoking to Electronic Nicotine Delivery System (ENDS) Use: A Daily Diary Investigation

Author

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  • Tamlin S. Conner

    (Department of Psychology, University of Otago, Dunedin 9054, New Zealand)

  • Jiaxu Zeng

    (Department of Preventive and Social Medicine, University of Otago, Dunedin 9054, New Zealand)

  • Mei-Ling Blank

    (Department of Preventive and Social Medicine, University of Otago, Dunedin 9054, New Zealand)

  • Vicky He

    (Department of Preventive and Social Medicine, University of Otago, Dunedin 9054, New Zealand)

  • Janet Hoek

    (Department of Public Health, University of Otago, Wellington 6242, New Zealand)

Abstract

Objectives: We aimed to examine patterns in smoking and electronic nicotine delivery system (ENDS) use over an extended period of time (up to 20 weeks) in people who smoked and who had never previously made a successful quit attempt using an ENDS. Design and setting: We conducted a longitudinal mixed-methods study in Dunedin, New Zealand, during 2018 and 2019. Participants: Purposively selected participants ( N = 45; age (≥18 years), gender, ethnicities, cigarettes/day) who wished to quit smoking. Interventions: Participants were provided with a second-generation ENDS device (vape pen or starter “tank” device) at the start of their quit attempt, and asked to complete smartphone-based daily diary surveys assessing smoking and ENDS use. Outcome measures: Sunburst plots and a sequence plot were used to describe weekly and daily patterns of smoking and ENDS use (smoking only, ENDS use only, dual use, abstinent). Results: The most frequently reported movements among participants, classified according to their study week behaviour, occurred between dual use and exclusive ENDS use (and vice versa). A smaller group reported moving from dual use to exclusive smoking (and often back to dual use), and a small number reported moving between abstinence and different ENDS and smoked tobacco usage behaviours. Data visualisations focussing on those participants who had provided data during each of weeks 9–12 indicate that only a minority reported sustained dual use; instead, most participants indicated varied smoked tobacco and ENDS use, which included periods of dual use. Conclusions: The considerable variety observed within and between study participants suggests that high variability is typical rather than exceptional. Transitions from smoking to ENDS use may involve considerable periods of dual use, which is likely to be dynamic and potentially sustained over several months.

Suggested Citation

  • Tamlin S. Conner & Jiaxu Zeng & Mei-Ling Blank & Vicky He & Janet Hoek, 2021. "A Descriptive Analysis of Transitions from Smoking to Electronic Nicotine Delivery System (ENDS) Use: A Daily Diary Investigation," IJERPH, MDPI, vol. 18(12), pages 1-13, June.
  • Handle: RePEc:gam:jijerp:v:18:y:2021:i:12:p:6301-:d:572640
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    References listed on IDEAS

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    1. Shannon Gravely & Gang Meng & K. Michael Cummings & Andrew Hyland & Ron Borland & David Hammond & Richard J. O’Connor & Maciej L. Goniewicz & Karin A. Kasza & Ann McNeill & Mary E. Thompson & Sara C. , 2020. "Changes in Smoking and Vaping over 18 Months among Smokers and Recent Ex-Smokers: Longitudinal Findings from the 2016 and 2018 ITC Four Country Smoking and Vaping Surveys," IJERPH, MDPI, vol. 17(19), pages 1-19, September.
    2. Socrates Yong-da Wu & Man Ping Wang & William H. Li & Antonio C. Kwong & Vienna W. Lai & Tai Hing Lam, 2018. "Does Electronic Cigarette Use Predict Abstinence from Conventional Cigarettes among Smokers in Hong Kong?," IJERPH, MDPI, vol. 15(3), pages 1-10, February.
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