Abstract P399: Two-Year Trends and Determinants of Electronic Cigarette Use Among Patients With Cardiovascular Disease in the United States

Abstract

Background: The use of electronic cigarettes (e-cigarettes) is on the rise in the US. It increased in adults aged 25-44 years from 2.4% in 2012 to 4.2% in 2016 and from 2% to 2.8% between ages 55 to 64 over the same period. Among the youth, the increase was 900% between 2011 and 2015. Much remains to be known about the health effects of e-cigarette use, but epidemiologic studies suggest an independent association between e-cigarette use and cardiovascular disease. There is a need for data on the social and demographic factors that are predictive of use in adults with cardiovascular disease (CVD), to identify the appropriate focus of intervention. Methods: This is an analysis of the 2016 and 2017 Behavioral Risk Factor Surveillance System (BRFSS) data, an annual chronic disease and behavioral risk factor survey conducted by the CDC. The sample included the 110,028 respondents that reported a history of heart attack, angina/coronary heart disease or stroke. The rates of e-cigarette use were calculated, and a multiple logistic regression analysis was used to assess associated factors. Results: Among respondents with CVD, there was no change in e-cigarette use between 2016 and 2017 [3.1% to 2.8% adjusted OR (aOR) 1.08 (95% CI 0.95 - 1.24)]. The median age of e-cigarette users was 58 years and that of non-users was 69 years (p<0.0001). Women had a higher rate of e-cigarette use compared with men [3.2% vs 2.7% aOR 1.17(1.04-1.31)]. Other factors associated with e-cigarette use were: race [blacks vs whites 1.9% vs 3% aOR 0.37(0.28-0.49], sexual orientation [LGBTQ vs non-LGBTQ 7.1% vs 2.9% aOR 1.56 (1.24-1.96)], smoking [current smokers vs non-smokers 11.1% vs 1.2% aOR 6.0 (5.3-6.8), smoking on some days vs never smoked 12.7% vs 0.24 aOR 51(35.4-73.5)], mental illness [6.4% vs 1.8% aOR 1.57 (1.37-1.810)] and state of residence (p<0.0001). Conclusion: In conclusion, there was no significant change in e-cigarette use between 2016-2017 among respondents with CVD. The highest rates of e-cigarette use were among subjects who were: smokers on some days, current smokers, LGBTQ and had a mental illness.