Prevalence and Distribution of E-Cigarette Use Among U.S. Adults: Behavioral Risk Factor Surveillance System, 2016.

Background: Contemporary data on the prevalence of e-cigarette use in the United States are limited. Objective: To report the prevalence and distribution of current e-cigarette use among U.S. adults in 2016. Design: Cross-sectional. Setting: Behavioral Risk Factor Surveillance System, 2016. Participants: Adults aged 18 years and older. Measurements: Prevalence of current e-cigarette use by sociodemographic groups, comorbid medical conditions, and states of residence. Results: Of participants with information on e-cigarette use (n = 466 842), 15 240 were current e-cigarette users, representing a prevalence of 4.5%, which corresponds to 10.8 million adult e-cigarette users in the United States. Of the e-cigarette users, 15% were never-cigarette smokers. The prevalence of current e-cigarette use was highest among persons aged 18 to 24 years (9.2% [95% CI, 8.6% to 9.8%]), translating to approximately 2.8 million users in this age range. More than half the current e-cigarette users (51.2%) were younger than 35 years. In addition, the age-standardized prevalence of e-cigarette use was high among men; lesbian, gay, bisexual, and transgender (LGBT) persons; current combustible cigarette smokers; and those with chronic health conditions. The prevalence of e-cigarette use varied widely among states, with estimates ranging from 3.1% (CI, 2.3% to 4.1%) in South Dakota to 7.0% (CI, 6.0% to 8.2%) in Oklahoma. Limitation: Data were self-reported, and no biochemical confirmation of tobacco use was available. Conclusion: E-cigarette use is common, especially in younger adults, LGBT persons, current cigarette smokers, and persons with comorbid conditions. The prevalence of use differs across states. These contemporary estimates may inform researchers, health care policymakers, and tobacco regulators about demographic and geographic distributions of e-cigarette use. Primary Funding Source: American Heart Association Tobacco Regulation and Addiction Center, which is funded by the U.S. Food and Drug Administration and National Heart, Lung, and Blood Institute.

Electronic Cigarette Use Prevalence, Associated Factors, and Pattern by Cigarette Smoking Status in the United States From NHANES (National Health and Nutrition Examination Survey) 2013-2014.

BACKGROUND: To examine the prevalence and patterns of recent electronic cigarette (e-cigarette) use in a nationally representative sample of US adults and adolescents. METHODS AND RESULTS: Using tobacco information from NHANES (National Health and Nutrition Examination Survey) 2013-2014, 5423 adults and 895 adolescents (aged 13-17 years) were included in this analysis. Demographic, tobacco use, and drug use information were self-reported. Recent e-cigarette use (within the previous 5 days) was stratified by smoking status. Of 125 e-cigarette users, 116 participants were aged ≥18 years, corresponding to 2.6% (95% confidence interval [CI], 2.0-3.1) and 1.21% (95% CI, 0.3-2.1) prevalence of e-cigarette use among US adults and adolescents, respectively. E-cigarette adult users were current smokers (68.1%), former smokers (23.7%), and never smokers (8.2%). The highest prevalence of e-cigarette use was among current smokers (8.2%; 95% CI, 6.3-10.1), followed by former smokers (2.7%; 95% CI, 1.4-4.1), and then never smokers (0.4%; 95% CI, 0.2-0.6). After adjusting for age, sex, and ethnicity, e-cigarette users had higher odds of being exposed to secondhand smoke (odds ratio: 6.3; 95% CI, 3.6-11.1) and drinking alcohol (odds ratio: 4.2; 95% CI, 1.8-10.0) and lower odds of having at least a college education or a higher income, compared with tobacco nonusers. CONCLUSIONS: Between 2013 and 2014, e-cigarette use in the United States was more common among younger people, those with low socioeconomic status, and current and former smokers. These findings will help inform future research as well as public policy and regulatory actions.

Revision and validation of a medication assessment tool for chronic cancer pain management.

The medication assessment tool for cancer pain management (MAT-CP) measures the quality of medication use in relation to guidelines. The original MAT-CP was reviewed, modified and tested at a comprehensive cancer center in Jordan. The tool comprised 30 criteria covering six different aspects of pain management. Seventy patients were included, males 41 (59%), females 29 (41%), mean age 49 (range, 20-79) years. The overall level of adherence to guidelines was 78% with good inter-rater reliability (κ= 0.899). The tool's implementation showed opportunities for improvement in pain management at our institution. The MAT-CP was revised and validated for the first time outside Europe. This tool can be routinely used to assess and compare the quality of pain management in different institutions.