Factors associated with smoking cessation in exclusive smokers and dual users of e-cigarette and conventional cigarettes from CDTnet registry

Dual use of electronic cigarettes and conventional cigarettes may be a transitional state towards cigarette smoking cessation. However, maintaining dual use may increase tobacco-related consequences as smoking behavior persists. The aim of our study was to describe characteristics of dual users and explore factors associated with their one-month abstinence in comparison to exclusive smokers in French smoking cessation services (SCS). We retrospectively studied 5116 smokers registered in a national SCS registry between 2015 and 2018 and who attended at least two visits. We matched the retained exclusive smokers and dual users by age, sex, professional status and education level. We compared baseline information and validated smoking abstinence at one-month follow-up between the two groups. Predictors of abstinence were assessed using a multivariate model. Retained exclusive smokers and dual users had similar cessation rates (37%). Compared to exclusive smokers, dual users presented more comorbidities and a higher level of nicotine dependence. Factors positively associated with cessation in dual users were: being employed or retired, declaring three or more previous quit attempts, pre-senting with low nicotine dependence and high motivation to quit and benefiting from at least four follow-up consultations. Our results suggest that dual users seeking help to quit in SCS seem to benefit from support as much as exclusive smokers to reach abstinence, despite a higher level of nicotine dependence and comorbidities. Further research, especially qualitative, is needed on this specific group of smokers to provide tailored in-terventions to quit.

Automated summary

The study aimed to explore factors associated with one-month abstinence in dual users compared to exclusive smokers in French smoking cessation services (SCS). The results showed that dual users had similar cessation rates as exclusive smokers, but presented more comorbidities and higher nicotine dependence levels. Predictors of abstinence in dual users included employment or retirement, multiple previous quit attempts, low nicotine dependence, high motivation to quit, and regular follow-up consultations. The findings suggest that dual users seeking help in SCS can benefit from support to achieve abstinence, despite their higher nicotine dependence and comorbidities. Further qualitative research is needed to provide tailored interventions for this specific group of smokers.