Abstract
IntroductionIn England, the use of electronic cigarettes as a smoking cessation aid has become more popular than any other aid. Previous research suggests that ex-smokers from lower social groups are more likely to use e-cigarettes compared to ex-smokers from more socially advantaged groups. The present study aimed to assess the association between baseline education, income and employment status and (1) baseline motivation to stop using e-cigarettes (2) attempts to stop using e-cigarettes during follow-up among current smokers, recent ex-smokers and long-term ex-smokers who use e-cigarettes. MethodsUK online longitudinal survey of smokers, ex-smokers and e-cigarette users, May/June 2016 (baseline) and September 2017 (follow-up). In logistic regression models, motivation to stop using e-cigarettes at baseline (n = 994) and attempts to stop using e-cigarettes at follow-up (n = 416) among current smokers and ex-smokers were regressed onto baseline educational attainment, income, employment status while adjusting for baseline demographics, vaping status, smoking and e-cigarette dependence. Results(1) Respondents with higher education (OR = 1.36; 95% CI: 1.06–1.74) or higher income (OR = 1.52; 95% CI: 1.17–1.98) were more likely to be motivated to stop using e-cigarettes, but only in unadjusted analysis. (2) Again, in unadjusted analysis only, employment was associated with reduced odds of attempting to stop using e-cigarette (OR = 0.50; 95% CI: 0.32–0.79). ConclusionHigher socio-economic status may be associated with higher motivation to stop vaping but with lower likelihood of trying to do so.
Highlights
In England, the use of electronic cigarettes as a smoking cessation aid has become more popular than any other aid
Smoking is unequally distributed between people of different socioeconomic status with higher smoking prevalence in groups with lower socioeconomic status (SES); this contributes to health inequalities (Hiscock, Bauld, Amos, Fidler, & Munafo, 2012; Hiscock, Dobbie, & Bauld, 2015)
In England, the use of electronic cigarettes (e-cigarettes) as a smoking cessation aid has become more popular than any other aid, including nicotine replacement therapy (NRT) (McNeill, Brose, Calder, Bauld, & Robson, 2018)
Summary
In England, the use of electronic cigarettes as a smoking cessation aid has become more popular than any other aid. Consistent with the diffusion of innovation model (Rogers, 2003) early studies found evidence of a social gradient in the use of e-cigarettes when they were first introduced (Adkison et al, 2013; Brown et al, 2014) These studies found that more socially advantaged “early adopters” of e-cigarettes showed greater awareness and use of e-cigarettes during a quit attempt compared to less socially advantaged groups. This social gradient seems to have attenuated over time and today is no longer evident (Kock, Shahab, West, & Brown, 2018); that is, less socially advantage groups are just as likely to use e-cigarettes as their more socially advantaged counterparts
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