Non-cigarette combustible tobacco use and its associations with subsequent cessation of smoking among daily cigarette smokers: findings from the International Tobacco Control Four Country Smoking and Vaping Surveys (2016-20)

Lin Li; Ron Borland; K Michael Cummings; Andrew Hyland; Michael Le Grande; Geoffrey T Fong; Ann McNeill

doi:10.1111/add.16023

Non-cigarette combustible tobacco use and its associations with subsequent cessation of smoking among daily cigarette smokers: findings from the International Tobacco Control Four Country Smoking and Vaping Surveys (2016-20)

Addiction. 2023 Jan;118(1):140-148. doi: 10.1111/add.16023. Epub 2022 Aug 16.

Authors

Lin Li¹, Ron Borland¹, K Michael Cummings^{2

3}, Andrew Hyland⁴, Michael Le Grande¹, Geoffrey T Fong^{5

6

7}, Ann McNeill^{8

9}

Affiliations

¹ Melbourne Centre for Behaviour Change, School of Psychological Sciences, University of Melbourne Parkville Campus, Parkville, VIC, Australia.
² Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA.
³ Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, USA.
⁴ Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA.
⁵ Department of Psychology, University of Waterloo, Waterloo, ON, Canada.
⁶ School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada.
⁷ Ontario Institute for Cancer Research, Toronto, ON, Canada.
⁸ National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
⁹ Shaping Public hEalth poliCies To Reduce ineqUalities and harm (SPECTRUM), London, UK.

PMID: 35938219
DOI: 10.1111/add.16023

Abstract

Aims: To examine whether polyuse of cigarettes and other smoked products (polysmoking) is predictive of quit attempts and quit success.

Design: A prospective multi-country cohort design.

Setting: Australia, Canada, England and the United States.

Participants: A total of 3983 adult daily cigarette smokers were surveyed in 2016 (wave 1 of data collection) and were re-contacted in 2018 (wave 2) (i.e. waves 1-2 cohort) in the International Tobacco Control Four Country Smoking and Vaping (ITC 4CV) surveys; and 3736 smokers were surveyed in 2018 and re-contacted in 2020 (wave 3) (i.e. waves 2-3 cohort).

Measurements: Participants were asked about their cigarette smoking and use of cigars, cigarillos, pipes and waterpipes. Outcomes were quit attempts between two survey waves and success, defined as having quit smoking all the combustible tobacco at the subsequent survey for 1 month or more.

Findings: Levels of polysmoking were 12.7% in the waves 1-2 cohort and 10.5% for the waves 2-3 cohort. Compared with cigarette-only smokers, polysmokers were more likely to attempt to quit between waves 1 and 2 [54.9 versus 42.7%, adjusted odds ratio (aOR) = 1.37, 95% confidence interval (CI) = 1.08-1.74, P < 0.01], but not between waves 2 and 3 (43.8 versus 40.1%, aOR = 0.94, 95% CI = 0.72-1.22). Polysmoking predicted reduced likelihood of success in both cohorts among attempters and the overall samples. Between waves 2 and 3 there were significantly more transitions to non-daily smoking among the polysmokers (12.4 versus 5.3%, χ² = 40.4, P < 0.001).

Conclusions: There is a consistent association between polysmoking (use of cigarettes together with other smoked products) and reduced quit success for combustible tobacco, but it is probably due to increased likelihood of transitioning to non-daily use rather than complete cessation.

Keywords: Combustible tobacco; longitudinal study; nicotine dependence; polysmoking; smoking cessation; survey.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Cigarette Smoking* / epidemiology
Electronic Nicotine Delivery Systems*
Humans
Nicotiana
Prospective Studies
Smokers
Smoking Cessation*
Tobacco Products*
United States / epidemiology
Vaping* / epidemiology

Grants and funding

P01 CA200512/CA/NCI NIH HHS/United States