Abstract
ABSTRACTBackground and aimsThe National Institute for Health and Care Excellence (NICE) has called for research into tobacco harm reduction across ethnicities, genders and socio‐economic status. Although there is increasing research focused on the latter two, relatively few studies have considered ethnic variations. Therefore this study aimed to assess (i) the association between ethnicity and use of e‐cigarettes and nicotine replacement therapy (NRT) for temporary abstinence and cutting down, and (ii) trends in prevalence of these over time.DesignRepeated cross‐sectional household survey.SettingEngland.ParticipantsBetween April 2013 and September 2019, data were collected on 24 114 smokers, 16+ of age, taking part in the Smoking Toolkit Study (STS).MeasurementsEthnicity coding included: White, mixed/multiple ethnic group, Asian, Black and Arab/other ethnic group. Smokers reported whether they were currently using e‐cigarettes and/or NRT for cutting down or during periods of temporary abstinence.FindingsOdds of e‐cigarette use for cutting down and temporary abstinence were significantly lower among those of Asian ethnicity (OR = 0.79, 95% CI = 0.66–0.93) and Arab/other ethnicity (OR = 0.58, 95% CI = 0.40–0.83) compared with White ethnicity. Those of mixed/multiple ethnicity had higher odds for NRT us (OR = 1.42, 95% CI = 1.04–1.94) compared with those of White ethnicity. Trend analysis indicated that for White ethnicity, e‐cigarette use by smokers for cutting down and temporary abstinence followed an ‘inverse S’ shaped cubic curve indicating an overall rise, whereas NRT use followed an ‘S’ shaped cubic curve, indicating an overall decline. For mixed/multiple ethnicity a similar trend was found for NRT use only, with other ethnicities showing no statistically significant trends (suggesting relative stability over time).ConclusionsIn England, e‐cigarette use by smokers for cutting down and temporary abstinence is less common among Asian and Arab/other ethnicity smokers compared with White smokers. Smokers of mixed/multiple ethnicity are the most likely to be using NRT compared with other ethnic groups for cutting down and temporary abstinence. E‐cigarette use by smokers for cutting down and temporary abstinence has increased over time among White smokers, whereas prevalence in other ethnic groups has remained stable.
Highlights
Background and aims The NationalInstitute for Health and Care Excellence (NICE) has called for research into tobacco harm reduction across ethnicities, genders and socio-economic status
Harm reduction involves any attempt to reduce the harm from smoking without the complete elimination of all tobacco constituents [9]; the most common forms being the use of Alternative Nicotine Delivery Systems (ANDS) for smoking reduction and temporary abstinence [10,11]
Between April 2013 and September 2019 data were collected on 132 597 adults of age 16+
Summary
England has an intermediate position that allows tightly regulated consumer sales. Regulations include a cross-border advertising ban, age-of-sale restrictions, minimum quality and safety standards and a notification system overseen by the Medicines and Healthcare Products Regulatory Agency (MHRA) [7]. England has quite a liberal approach to nicotine replacement therapy (NRT), which is available both over-the-counter and as a medication and includes an indication for harm reduction. Many smokers use these products as a smoking cessation aid, an increasing number are opting Addiction. Harm reduction involves any attempt to reduce the harm from smoking without the complete elimination of all tobacco constituents [9]; the most common forms being the use of Alternative Nicotine Delivery Systems (ANDS) for smoking reduction (i.e. cutting down) and temporary abstinence (i.e. periods of time when one is unable to smoke) [10,11]
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