Documentation of e-cigarette use and associations with smoking from 2012 to 2015 in an integrated healthcare delivery system

PREVENTIVE MEDICINE

卷:109

Article

Young-Wolff, Kelly C.¹  Klebaner, Daniella¹  Folck, Bruce¹  Tan, Andy S. L.^2,3  Fogelberg, Renee⁴  Sarovar, Varada¹  Prochaska, Judith J.⁵ 

[1] Kaiser Permanente Northern Calif, Div Res, 2000 Broadway, Oakland, CA 94612 USA

[2] Harvard TH Chan Sch Publ Hlth, Dept Social & Behav Hlth, Boston, MA USA

[3] Dana Farber Canc Inst, Boston, MA 02115 USA

[4] Kaiser Permanente Northern Calif, Richmond Med Ctr, Richmond, CA USA

[5] Stanford Univ, Stanford Prevent Res Ctr, Stanford, CA 94305 USA

关键词: e-Cigarette;    ENDS;    Vaping;    Smoking;    Cigarettes;    Electronic health record;    EHR;    Provider documentation;    Clinician;   

DOI  :  10.1016/j.ypmed.2018.01.012

来源: Elsevier

【 摘 要 】

It is unclear whether use of electronic nicotine delivery systems (ENDS) precedes cigarette smoking initiation, relapse, and/or quitting. Healthcare systems with electronic health records (EHRs) provide unique data to examine ENDS use and changes in smoking. We examined the incidence of ENDS use (2012-2015) based on clinician documentation and tested whether EHR documented ENDS use is associated with twelve-month changes in patient smoking status using a matched retrospective cohort design. The sample was Kaiser Permanente Northern California (KPNC) patients aged >= 12 with documented ENDS use (N= 7926); 57% were current smokers, 35% former smokers, and 8% neversmokers. ENDS documentation incidence peaked in 2014 for current and former smokers and in 2015 for neversmokers. We matched patients with documented ENDS use to KPNC patients without documented ENDS use (N= 7926) on age, sex, race/ethnicity, and smoking status. Documented ENDS use predicted the likelihood of smoking in the following year. Among current smokers, ENDS use was associated with greater odds of quitting smoking (OR=1.17, 95% CI= 1.05-1.31). Among former smokers, ENDS use was associated with greater odds of smoking relapse (OR= 1.53, 95% CI= 1.22-1.92). Among never-smokers, ENDS use was associated with greater odds of initiating smoking (OR= 7.41, 95% CI= 3.14-17.5). The overall number of current smokers at 12 months was slightly higher among patients with (N= 3931) versus without (N= 3850) documented ENDS use. esults support both potential harm reduction of ENDS use (quitting combustibles among current smokers) and potential for harm (relapse to combustibles among former smokers, initiation for never-smokers).

【 授权许可】

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