Association of cancer information seeking behavior with cigarette smoking and E-cigarette use among U.S. adults by education attainment level: A multi-year cross-sectional analysis from a nationally representative sample in 2017–2020

Abstract

Little is known about the association of cancer information seeking behavior with cigarette smoking and e-cigarette use. A multi-year cross-sectional analysis using a pooled data of the Health Information National Trends Survey 5, Cycles 1–4 (2017–2020) was conducted. To examine the association of cancer information seeking behavior with current cigarette smoking (currently smoke every day/some days among individuals who smoked 100+ cigarettes in lifetime) and e-cigarette use (currently use every day/some days among lifetime users) in nationally representative U.S. adults, we conducted weighted multiple logistic regression analysis, adjusting for sex, race/ethnicity, age, obese status, depressed mood, cancer diagnosis history, metropolitan status, and survey year. The regression models were stratified by education level (<college and ≥ college). Individuals in 18–25 years old were excluded as they have not likely completed their education. A final analytic sample included 12,430 adults. Cancer information seekers had lower odds of cigarette smoking than non-seekers, but this was observed in only ≥college group (Adjusted odds ratio [AOR] = 0.78, 95% confidence interval [CI] = 0.61, 0.99). Conversely, cancer information seekers had higher odds of e-cigarette use than non-seekers, but this was significant in only <college group (AOR = 2.12, 95% CI = 1.18, 3.83). Cancer information seeking behavior might help to reduce cigarette smoking when seekers had ≥college education. However, cancer information seeking behavior might positively influence e-cigarette use in <college group. A proper/easy-to-understand dissemination of proven cancer information regarding cigarette smoking and e-cigarette use considering the unproven cancer risk of e-cigarette use is recommended for less educated individuals.