E-Cigarette Use Among Adult Primary Care Patients: Results from a Multisite Study.
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BACKGROUND:Primary care settings provide opportunities to identify electronic-cigarette (e-cigarette) use and to implement strategies for changing tobacco use behavior. However, a better understanding of the extent and associated characteristics of e-cigarette use among primary care patients are needed to inform such efforts. OBJECTIVE:To describe patient demographic and substance use characteristics by e-cigarette use status among a large sample of primary care patients. To examine the prevalence and correlates of e-cigarette use among tobacco users in the sample. DESIGN:Cross-sectional analysis from a multisite validation study of a substance use screening instrument. PARTICIPANTS:Adult primary care patients aged 18 and older (n = 2000) recruited across 5 primary care clinics in the Eastern USA from 2014 to 2015. MAIN MEASURES:Patients reported past 3-month e-cigarette use, sociodemographics, tobacco use, and other substance use. Current nicotine dependence and DSM-5 criteria for past-year substance use disorders were also assessed. KEY RESULTS:Among the total sample, 7.7% (n = 154) adults reported past 3-month e-cigarette use. Adults who reported e-cigarette use (vs. no use) were more likely to be younger, white, or have frequent tobacco use, nicotine dependence, or past-year illicit drug use/disorders. Among past 3-month tobacco users, 16.3% reported e-cigarette use. Adjusted logistic regression indicated that odds of e-cigarette use were greater among tobacco users who had some college education or more (vs. < high school) or were daily/almost daily tobacco users (vs. not); odds were lower among Blacks/African-Americans (vs. whites). E-cigarette use among tobacco users was associated with increased odds of current nicotine dependence or tobacco use disorder as well as more severe dependence/disorder. CONCLUSIONS:Enhanced surveillance of e-cigarette use among adult tobacco users in primary care, particularly among those who use tobacco frequently, may have implications for helping patients with tobacco cessation using established approaches including behavioral support, pharmacotherapy, or referral to specialized care.
Published Version (Please cite this version)10.1007/s11606-019-05488-4
Publication InfoJohn, William S; Grover, Kiran; Greenblatt, Lawrence H; Schwartz, Robert P; & Wu, Li-Tzy (2020). E-Cigarette Use Among Adult Primary Care Patients: Results from a Multisite Study. Journal of general internal medicine, 35(1). pp. 268-275. 10.1007/s11606-019-05488-4. Retrieved from https://hdl.handle.net/10161/19919.
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Professor of Medicine
Dr. Greenblatt focuses his professional efforts in 3 domains. First, he provides care to a busy general internal medicine panel utilizing an approach that is both patient-centered and evidence-based. Second, he is an active educator routinely providing clinical teaching to students and residents. He routinely regularly provides faculty development in teaching and other skills for medical educators across many professions both in Durham and in the Academic Medicine Education In
Assistant Professor in Psychiatry and Behavioral Sciences
Professor in Psychiatry and Behavioral Sciences
Education/Training: Pre- and post-doctoral training in mental health service research, psychiatric epidemiology (NIMH T32), and addiction epidemiology (NIDA T32) from Johns Hopkins University School of Public Health (Maryland); Fellow of the NIH Summer Institute on the Design and Conduct of Randomized Clinical Trials.Director: Duke Community Based Substance Use Disorder Research Program.Research interests: COVID-19, Opioid misuse, Opioid overdose, Opioid use disorder
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