E-cigarette use and United States Preventive Services Task Force (USPSTF) lung cancer screening (LCS) eligibility.

person Qian Wang University Hospitals Seidman Cancer Center and Case Western Reserve University, Cleveland, OH info_outline Qian Wang, Changchuan Jiang, Hui Xie, Zhiting Tang, Yannan Li, Chi Wen, Melinda Laine Hsu, Debora S. Bruno, Yaning Zhang, Afshin Dowlati, Lauren Chiec, Giselle Dutcher, Paolo Boffetta, Chung Yin Kong, Matthew M. Mirsky

Authors person Qian Wang University Hospitals Seidman Cancer Center and Case Western Reserve University, Cleveland, OH info_outline Qian Wang, Changchuan Jiang, Hui Xie, Zhiting Tang, Yannan Li, Chi Wen, Melinda Laine Hsu, Debora S. Bruno, Yaning Zhang, Afshin Dowlati, Lauren Chiec, Giselle Dutcher, Paolo Boffetta, Chung Yin Kong, Matthew M. Mirsky Organizations University Hospitals Seidman Cancer Center and Case Western Reserve University, Cleveland, OH, UT Southwestern Medical Center, Dallas, TX, Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, WI, Department of Medicine, Unity Hospital, Rochester Regional Health, Rochester, NY, School of Population and Public Health, The University of British Columbia, Vancouver, BC, Canada, Quality Operations, Mount Sinai Health System, New York, NY, Case Western Reserve University; University Hospitals Seidman Cancer Center, Cleveland, OH, Case Comprehensive Cancer Center, University Hospitals Seidman Cancer Center, Cleveland, OH, Sentara Halifax Regional Hospital, South Boston, VA, Stony Brook University, Stony Brook, NY, Icahn School of Medicine at Mount Sinai, New York, NY Abstract Disclosures Research Funding No funding sources reported Background: Electronic cigarettes (E-cigarettes) have become frequently used as a smoking cessation tool. Emerging research has shown that e-cigarettes have similar carcinogenic effects as combustible cigarettes. While current lung cancer screening (LCS) guidelines primarily rely on individuals’ smoking history, it's becoming increasingly important to understand the prevalence of e-cigarette use among individuals, especially in the context of their LCS eligibility. Methods: Individuals aged 40-80 years were extracted from the 2022 Behavioral Risk Factor Surveillance System. Eligibility was defined using the 2021 USPSTF LCS criteria, i.e., aged 50-80 years who ever smoked, with at least a 20-pack-year smoking history, currently smoke or quit within the past 15 years. We compared the prevalence of current and ever e-cigarette use among LCS-eligible and non-eligible populations, overall and by smoking (combustible cigarettes) status using chi-square tests. All analyses were weighted. The significance level was set at a 2-sided p-value of <0.05. Results: Among the 208,317 individuals included, 9.9% were eligible for LCS. Overall, 3.8% and 22.1% reported current and ever cigarette use, respectively. Fewer LCS-ineligible individuals reported currently using e-cigarettes than their LCS-eligible counterparts (Table). Among former combustible cigarette users, LCS-ineligible individuals were less likely to be current e-cigarette user than LCS-eligible individuals. However, among current combustible cigarette users, LCS-ineligible individuals were more likely to be current e-cigarettes users than LCS-eligible individuals. When examining the prevalence of ever e-cigarette use, similar findings were observed. Conclusions: Our study reveals a significant prevalence of e-cigarette usage among older adults (aged 40-80), with 1 in 5 individuals reporting ever having used e-cigarettes. Moreover, current cigarette users who were ineligible for LCS were more likely to use e-cigarette than their LCS-eligible counterparts. Future epidemiological studies are warranted to assess the risk of e-cigarette use (including intensity, duration and interactions with combustible cigarettes) and lung cancer risks. E-cigarette use may need to be considered in formulating future LCS guidelines. Prevalence of e-cigarette use by LCS eligibility. LCS-ineligible LCS-eligible P-value LCS-ineligible LCS-eligible P-value Current e-cigarette use (weighted % 95%CI) Ever e-cigarette use (weighted % 95%CI) Overall 3.2 (3.0-3.4) 9.3 (8.5-10.0) <0.0001 19.6 (19.2-20.1) 44.6 (43.3-45.9) <0.0001 By combustible cigarette use status Never 0.8 (0.7-0.9) NA NA 12.0 (11.5-12.4) NA NA Current 12.9 (11.8-14.0) 7.4 (6.4-8.3) <0.0001 51.9 (50.2-53.5) 46.0 (44.4-47.7) <0.0001 Former 6.0 (5.5-6.6) 12.0 (10.7-13.3) <0.0001 28.4 (27.4-29.3) 42.6 (40.5-44.6) <0.0001