Prevalence, Reasons for Use, and Risk Perception of Electronic Cigarettes Among Post-Acute Coronary Syndrome Smokers.
OBJECTIVE
The use of electronic cigarettes (e-cigarettes) has risen dramatically in recent years. However, there are currently no published data on the use of e-cigarettes among cardiac patients. The current study reports on the prevalence, reasons for use, and perceived risks of e-cigarettes among patients with post-acute coronary syndrome (ACS). The relationship between e-cigarette use and post-ACS tobacco smoking cessation is also explored.


METHODS
Participants were drawn from a randomized trial of smoking cessation treatments following hospitalization for ACS. The current study focused on 49 participants who completed e-cigarette questions at 24 weeks post-ACS.


RESULTS
Of the 49 of participants, 51.0% reported ever use of an e-cigarette and 26.5% reported using an e-cigarette at some time during the 24 weeks post-ACS. Ever use and post-ACS use were both significantly associated with lower rates of abstinence from tobacco cigarettes. Participants perceived e-cigarettes as less harmful to cardiac health than tobacco use and Chantix (varenicline), and similarly harmful as nicotine replacement therapy. Participant perceived likelihood of experiencing a heart attack in the next year was 34.6% if they were to regularly use only e-cigarettes, significantly lower than the perceived risk of recurrence if they were to regularly smoke only tobacco cigarettes (56.2%) and significantly higher than the perceived risk of recurrence if they were to use no nicotine (15.2%).


CONCLUSIONS
A significant minority of patients are using e-cigarettes post-ACS. Providers should be prepared to discuss potential discrepancies between patient beliefs about the safety of e-cigarettes and the current state of the science.
The Miriam Hospital, Centers for Behavioral and Preventive Medicine (Dr Busch) and Department of Psychiatry (Dr Buckley) Providence, Rhode Island; The Warren Alpert Medical School of Brown University, Providence, Rhode Island (Drs Busch and Buckley); Oklahoma State University, Department of Psychology, Stillwater, Oklahoma (Ms Leavens); Oklahoma Tobacco Research Center, Oklahoma City, Oklahoma (Dr Wagener and Ms Leavens); University of Oklahoma Health Sciences Center, Department of Pediatrics, Oklahoma City, Oklahoma (Dr Wagener); and Roger Williams University, Department of Psychology, Bristol, Rhode Island (Dr Tooley).
Andrew M
AM
Busch
Eleanor L
EL
Leavens
Theodore L
TL
Wagener
Maria L
ML
Buckley
Erin M
EM
Tooley
D054058:Acute Coronary Syndrome / Q000209:etiology; D000328:Adult; D000368:Aged; D000073865:Cigarette Smoking / Q000009:adverse effects; D066300:Electronic Nicotine Delivery Systems / Q000706:statistics & numerical data; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology; D010465:Perception; D012008:Recurrence; D012307:Risk Factors; D016540:Smoking Cessation