Pilot Project 5

Pilot PI: Hermine Poghosyan, PhD, MPH, RNweb-poghosyan-h-nu

Title: Electronic and Tobacco Cigarettes Use Among Individuals At High Risk for Lung Cancer

Summary

Cigarette smoking is the main risk factor for developing lung cancer;87% of all lung cancer cases are related to tobacco exposure. Racial and ethnic disparities in lung cancer prevalence and mortality are well documented. Compared to other racial/ethnic groups, African Americans suffer higher incidence and mortality rates from lung cancer. Providing smoking cessation to smokers is essential for the prevention of lung cancer. Many smokers want to quit tobacco. In fact, 68.8% of adult tobacco smokers wanted to quit smoking, 52.4% had made a quit attempt in the past year, while only 6.2% had recently quit in 2010. The challenges associated with smoking cessation may lead some smokers to explore other options as a means to quit smoking.

Though not approved by the U.S. Food and Drug Administration (FDA) as smoking cessation aids, e-cigarettes are marketed as alternatives to smoking and may help current smokers reduce or quit tobacco use. Moreover, the U.S. Preventive Task Force and Centers for Disease Control and Prevention (CDC) recently concluded that due to insufficient scientific evidence e-cigarettes are not recommended as smoking cessation method in adults. Adults report various motivations for e-cigarette use, citing smoking cessation as the common reason. Still, many e-cigarette users fail to completely substitute smoking, and thus become “dual users”. Individuals will have increased level of nicotine addiction when e-cigarettes are used in addition to traditional tobacco cigarettes. Yet, no studies have been conducted to examine the trends in use of e-cigarette across racial/ethnic groups of current smokers who are at high-risk for developing lung cancer and nothing is known about the prevalence of e-cigarette use among high-risk current smokers. While many smokers want to quit, few are able to do so successfully. Published evidence has documented that stress is associated with less success in quitting smoking. In high stress situations, individuals reach for cigarettes. This study will help to understand the triggers and the level of stress that causes participants to smoke. This study aims to:

  1. Determine the prevalence of e-cigarette use across racial/ethnic groups of current smokers
    who are at high risk for developing lung cancer.
  2. Describe the attitudes and risk perceptions related to e-cigarette among current smokers from
    different racial/ethnic backgrounds.
  3. Determine factors associated with dual use of e-cigarette and tobacco cigarettes across
    racial/ethnic groups and identify characteristics of current smokers who might be interested in
    using e-cigarette for harm reduction or cessation.
  4. Test the feasibility, accuracy and usability of a wearable electrodermal activity sensor and
    mobile assessment to understand the stress levels and stress precipitators as they relate to
    craving and smoking triggers for African American men who are current smokers.

It is important to understand how e-cigarette use impacts individuals’ perceptions of the risks and their ability to lead a healthy lifestyle. Reducing the burden of lung cancer requires understanding the dual users perception so that effective smoking cessation programs may be developed. This work also will help develop a stress-management training/intervention that would provide current smokers information about how to avoid certain situations that causing them to smoke. This project has the potential to inform the development of effective smoking cessation program that in longer term will prevent lung cancer by reducing exposure to tobacco smoke.