title: Attitudes toward E-Cigarettes, Reasons for Initiating E-Cigarette Use, and Changes in Smoking Behavior after Initiation: A Pilot Longitudinal Study of Regular Cigarette Smokers.
abstract: OBJECTIVE
  We examined 1) changes in smoking and vaping behavior and associated cotinine levels and health status among regular smokers who were first-time e-cigarette purchasers and 2) attitudes, intentions, and restrictions regarding e-cigarettes.
  
  
  METHODS
  We conducted a pilot longitudinal study with assessments of the aforementioned factors and salivary cotinine at weeks 0, 4, and 8. Eligibility criteria included being ≥18 years old, smoking ≥25 of the last 30 days, smoking ≥5 cigarettes per day (cpd), smoking regularly ≥1 year, and not having started using e-cigarettes. Of 72 individuals screened, 40 consented, 36 completed the baseline survey, and 83.3% and 72.2% were retained at weeks 4 and 8, respectively.
  
  
  RESULTS
  Participants reduced cigarette consumption from baseline to week 4 and 8 (p's < 0.001); 23.1% reported no cigarette use in the past month at week 8. There was no significant decrease in cotinine from baseline to week 4 or 8 (p's = ns). At week 8, the majority reported improved health (65.4%), reduced smoker's cough (57.7%), and improved sense of smell (53.8%) and taste (50.0%). The majority believed that e-cigarettes versus regular cigarettes have fewer health risks (97.2%) and that e-cigarettes have been shown to help smokers quit (80.6%) and reduce cigarette consumption (97.2%). In addition, the majority intended to use e-cigarettes as a complete replacement for regular cigarettes (69.4%) and reported no restriction on e-cigarette use in the home (63.9%) or car (80.6%).
  
  
  CONCLUSIONS
  Future research is needed to document the long-term impact on smoking behavior and health among cigarette smokers who initiate use of e-cigarettes.
authors.affiliation: Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, USA.
authors.forename: Carla J
authors.initials: CJ
authors.lastname: Berg
authors.affiliation: Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, USA.
authors.forename: Dana Boyd
authors.initials: DB
authors.lastname: Barr
authors.affiliation: Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, USA.
authors.forename: Erin
authors.initials: E
authors.lastname: Stratton
authors.affiliation: Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, USA.
authors.forename: Cam
authors.initials: C
authors.lastname: Escoffery
authors.affiliation: Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, USA.
authors.forename: Michelle
authors.initials: M
authors.lastname: Kegler
keywords: Cessation; E-Cigarettes; Harm Reduction; Longitudinal Study; Nicotine Biomarkers