title: Electronic cigarette use among patients with cancer: characteristics of electronic cigarette users and their smoking cessation outcomes.
abstract: BACKGROUND
  Given that continued smoking after a cancer diagnosis increases the risk of adverse health outcomes, patients with cancer are strongly advised to quit. Despite a current lack of evidence regarding their safety and effectiveness as a cessation tool, electronic cigarettes (E-cigarettes) are becoming increasingly popular. To guide oncologists' communication with their patients about E-cigarette use, this article provides what to the authors' knowledge is the first published clinical data regarding E-cigarette use and cessation outcomes among patients with cancer.
  
  
  METHODS
  A total of 1074 participants included smokers (patients with cancer) who recently enrolled in a tobacco treatment program at a comprehensive cancer center. Standard demographic, tobacco use history, and follow-up cessation outcomes were assessed.
  
  
  RESULTS
  A 3-fold increase in E-cigarette use was observed from 2012 to 2013 (10.6% vs 38.5%). E-cigarette users were more nicotine dependent than nonusers, had more prior quit attempts, and were more likely to be diagnosed with thoracic and head or neck cancers. Using a complete case analysis, E-cigarette users were as likely to be smoking at the time of follow-up as nonusers (odds ratio, 1.0; 95% confidence interval, 0.5-1.7). Using an intention-to-treat analysis, E-cigarette users were twice as likely to be smoking at the time of follow-up as nonusers (odds ratio, 2.0; 95% confidence interval, 1.2-3.3).
  
  
  CONCLUSIONS
  The high rate of E-cigarette use observed is consistent with recent articles highlighting increased E-cigarette use in the general population. The current longitudinal findings raise doubts concerning the usefulness of E-cigarettes for facilitating smoking cessation among patients with cancer. Further research is needed to evaluate the safety and efficacy of E-cigarettes as a cessation treatment for patients with cancer.
authors.affiliation: Behavioral Sciences Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, NY.
authors.forename: Sarah P
authors.initials: SP
authors.lastname: Borderud
authors.forename: Yuelin
authors.initials: Y
authors.lastname: Li
authors.forename: Jack E
authors.initials: JE
authors.lastname: Burkhalter
authors.forename: Christine E
authors.initials: CE
authors.lastname: Sheffer
authors.forename: Jamie S
authors.initials: JS
authors.lastname: Ostroff
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D066300:Electronic Nicotine Delivery Systems; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology*; D016540:Smoking Cessation
keywords: cancer; electronic cigarettes (E-cigarettes); smoking cessation; tobacco