Smokers who have not tried alternative nicotine products: a 2019 survey of adults in Great Britain

Erikas Simonavicius,Ann Mcneill,Leonie S Brose,Hazel Cheeseman,Deborah Arnott

doi:10.1186/s12954-020-00391-2

Erikas Simonavicius, Ann Mcneill + Show 3 more

Open Access

https://doi.org/10.1186/s12954-020-00391-2

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Abstract

AimsSwitching from smoking to using nicotine replacement therapy (NRT), electronic cigarettes (e-cigarettes) or heated tobacco products can reduce tobacco-related health risks. However, not all smokers in Great Britain have tried these products. This study aimed to identify and describe smokers who have never tried alternative nicotine products.MethodsWe analysed cross-sectional survey data of smokers (n = 1777) from a representative adult sample from Great Britain. The online survey was run in March 2019. The proportion of smokers who had never used alternative nicotine products was measured. A multivariate logistic regression assessed the association between never having used alternative nicotine products and sociodemographic and smoking characteristics and motivation to stop smoking.ResultsOne in four smokers (27.8%, 95% CI 25.8–29.9%) had never tried NRT, e-cigarettes or heated tobacco products. These smokers were more commonly from Black and Minority than White ethnic groups (AOR = 1.55; 95% CI 1.02–2.31), were more likely to smoke up to 10 versus more cigarettes per day (AOR = 1.52; 95% CI 1.14–2.03) and to report low versus moderate or high motivation to stop smoking (AOR = 1.79; 95% CI 1.20–2.74).ConclusionLight smokers, those unmotivated to stop and smokers from Black and Minority ethnic groups are less likely to have ever tried alternative nicotine products. Different approaches are needed to facilitate harm reduction and smoking cessation among these groups of smokers.

Highlights

Nicotine-containing products have a continuum of health risks, and tobacco smoking occupies the most harmful end of this continuum [1]
Since the late 1970s when nicotine gum was released as a smoking cessation aid for smokers, multiple trials have shown that nicotine replacement therapy (NRT) is effective for reducing and stopping smoking in clinical [3] but less so in real-world settings [4]
27.8% had never tried any of the alternative nicotine products (Table 1)

Summary

Introduction

Nicotine-containing products have a continuum of health risks, and tobacco smoking occupies the most harmful end of this continuum [1]. Since the late 1970s when nicotine gum was released as a smoking cessation aid for smokers, multiple trials have shown that NRT is effective for reducing and stopping smoking in clinical [3] but less so in real-world settings [4]. E-cigarettes’ effectiveness for smoking cessation has been shown in clinical and real-world studies in the UK [5, 6] and they are used by a third of smokers trying to quit [7]. Concurrent use of NRT or e-cigarettes while smoking is unlikely to substantially reduce exposure to harmful toxicants [8]. Getting nicotine from alternative products helps smokers to reduce the number of cigarettes smoked [9] and facilitates quit attempts [10]. Compared with smokers not using alternative nicotine products, NRT users have made more recent attempts to quit smoking [4], and smokers who use e-cigarettes are more motivated to stop smoking [11]

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