Electronic cigarette use and cigarette smoking among Australian women

Background. E-cigarette use is a globally contentious topic. Most of the previous studies on e-cigarette use have not examined differences in usage in relation to gender. The findings regarding the association between e-cigarette use and subsequent cigarette smoking initiation and smoking cessation are also inconsistent. In Australia, no studies have investigated the association between e-cigarette use and smoking initiation among young adults who have never smoked. Additionally, few population-based longitudinal studies have investigated the association of e-cigarette use with smoking cessation, either internationally or in Australia. This thesis aims to identity and investigate the risk and protective factors of e-cigarette use and the role that e-cigarettes play in smoking initiation and cessation in Australian women. Methods. This thesis uses online survey data collected from the new young cohort of Australian women who were born between 1989 and 1995 and who participated in the Australian Longitudinal Study on Women’s Health. The research was conducted to identify the risk and protective factors of e-cigarette use and the role that e-cigarettes play in smoking initiation and smoking cessation. Results. Young age, smoking status, alcohol use, intimate partner violence and adverse childhood experiences (i.e., traumatic childhood experiences) were identified as factors that positively associated with e-cigarette use in the study population. This thesis discovered that although ever e-cigarette use is associated with subsequent cigarette smoking among never smokers, it also hinders subsequent cigarette smoking cessation among current smokers. Conversely, an umbrella review found that most nicotine and non-nicotine drugs (e.g., NRT, bupropion and varenicline) are effective treatments for smoking cessation. Conclusions. Certain efforts are required to prevent young people and non-smokers from nicotine addiction that is acquired through e-cigarette use. Subsequent interventions to curb the use of e-cigarettes among young Australian women should target risk factors such as young people, alcoholics, people with a history of intimate partner violence and people exposed to childhood adversities.