Prevalence of cigarette and e-cigarette use among U.S. adults eligible for lung cancer screening based on updated USPSTF guidelines.

BACKGROUND

The United States Preventative Services Taskforce recently updated lung cancer screening guidelines for U.S. adults with high-risk smoking histories. This has generated a previously undescribed patient population in which the prevalence of cigarette and e-cigarette use has not been described.

METHODS

We performed a cross-sectional study using population-based data from the Behavioral Risk Factor Surveillance System (2017-2018). We defined lung cancer screening eligibility as adults 50-80 years old with ≥ 20 pack-year smoking history who were currently smoking or quit within the last 15 years. We assessed several smoking-related outcomes including current cigarette use, ever e-cigarette use, and current e-cigarette use among respondents.

RESULTS

Among 7541 screening-eligible adults, current cigarette use was reported by 3604 (47.8%) participants. Ever and current e-cigarette use were reported by 3003 (39.8%) and 670 (8.9%) participants, respectively. Compared to individuals who were previously eligible for screening, individuals newly eligible for screening (i.e., between 50 and 55 years old with a 20-30 pack-year smoking history) were more likely to currently smoke (aOR 1.828, 95% CI 1.649-2.026, p < 0.001). While newly eligible respondents were more likely to report a history of ever using an e-cigarette (aOR 1.144, 95% CI 1.034-1.266, p = 0.009), current e-cigarette use was similar in this group compared to those individuals who were previously screening-eligible (aOR 1.014, 95% CI 0.844-1.219, p = 0.88).

CONCLUSIONS

Cigarette and e-cigarette exposure are common among U.S. adults who are eligible for lung cancer screening. Expanded USPSTF criteria will capture a patient population with greater exposure to both of these products.