E-cigarette Knowledge, Attitudes, and Use in Opioid Dependent Smokers

• We assessed e-cigarette usage and perceptions in opioid dependent individuals.
• We compared e-cigs in methadone-maintained vs. buprenorphine-maintained persons.
• 98.7% had heard of e-cigarettes, and 73.0% reported they had ever tried e-cigs.
• Curiosity (41.4%) was the most frequently reported reason for last use.
• Nearly two-thirds of respondents believed e-cigs were less harmful than cigarettes.

Individuals in treatment for opioid dependence have smoking rates 3–5 times greater than the U.S. prevalence rate. Traditional smoking cessation strategies have been ineffective in this population. Novel approaches are needed as well as harm reduction avenues. E-cigarettes (e-cigs) may provide such a novel harm reduction and cessation opportunity, but little is known about the knowledge of, attitudes about, and usage of e-cigs in opioid dependent smokers. The current study enrolled 315 opioid dependent smokers (164 methadone, 151 buprenorphine), treated in the same health system in Fall River, Massachusetts. The sample was 49.7% male and 85.1% non-Latino White. Overall 98.7% had heard of e-cigs, 73.0% had ever tried e-cigs, and 33.8% had used e-cigs in the past 30 days. The most common reasons for use were curiosity (41.4%) and to quit all nicotine (26.0%). The proportion of opioid dependent smokers that had ever tried e-cigs and used them in the past month was substantially greater than that found in recent general population surveys. While e-cigs have been used to quit smoking, how to optimize their utility as a cessation tool remains undefined. E-cigs should be a part of smoking cessation discussions with this vulnerable, difficult-to-treat population.