Ohio Nurse December 2021

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Page 14 Ohio Nurse December 2021 E-Cigarette and Subsequent Smoking Use and Relationship to E-Cigarette Quit Attempts Among College Students Michelle Correa, RN Reprinted with permission from Arizona Nurse April 2021 issue Electronic cigarette (e-cigarette) use increased three-fold from 2011 to 2013 and continues to gain prevalence among preteens, adolescents, and young adults (Centers for Disease Control and Prevention [CDC], 2014). E-cigarettes, including vape, JUUL, and wax pens, are defined as a device that does not contain tobacco but may include nicotine, flavorings, and other chemicals (National Cancer Institute, n.d.). With multiple marketing methods, e-cigarettes dominate in sales by targeting young and old generations (CDC, 2014). Many youth and young adults believe that e-cigarettes are cheaper, cleaner, safer, and healthier than traditional smoking (Gorukanti et al., 2017; Kong et al., 2015). Related to these perceptions, many young users (40.36%) believe that e-cigarettes help people discontinue cigarette smoking (Gorukanti et al., 2017). Both non-users, who have never used e-cigarettes or cigarettes, and e-cigarette users agree that e-cigarettes do not contain tar, are not addictive nor considered a tobacco product, and solely produce vapor with water (Gorukanti et al., 2017). Though perceived as a “safer” alternative to cigarettes, e-cigarettes are still not safe. Research indicates that while e-cigarettes may be a cessation aid for cigarette smokers, the product may produce the adverse effect of a nicotine addiction and/or combustible tobacco product use (Kong et al., 2015; Pattinson et al., 2018). Individuals not aware of the consequences of e-cigarettes may exacerbate current medical problems (i.e., asthma, respiratoryrelated issues, hypertension, cardiovascular diseases), continue their nicotine addiction through e-cigarette use, or initiate a nicotine addiction had they not smoked before (CDC, 2014). The U.S. Department of Health and Human Services (2016) reported consequences related to e-cigarette use, like addiction, brain development and subsequent mental health issues, chronic disease development, and death. In 2020, I conducted a cross-sectional study that included an anonymous screening survey and a survey that assessed e-cigarette use and non-electronic smoking, e-cigarette withdrawal and cessation, and non-electronic smoking quit attempts. I recruited 65 eligible* participants via flyer advertisements, social media advertisements, ASU online advertisements, and email notices. The study revealed that participants who used nonelectronic smoking also frequently used cigarettes or marijuana. Participants who used both electronic and non-electronic smoking preferred using e-cigarettes to non-electronic forms. Participants who attempted to quit e-cigarettes believed that they would successfully withdraw from e-cigarettes by switching to marijuana or avoiding non-electronic smoking altogether. Using these findings and previous research, youth and young adults seeking e-cigarette cessation need nursing education and intervention. We can help this population quit by applying principles of the nursing process. Ask patients about their e-cigarette habits, such as e-cigarette frequency, perceived e-cigarette harm to self, e-cigarette device, primary flavor use, nicotine presence, and reason for e-cigarette use. A more objective scale to assess for e-cigarette use and potential withdrawal severity is the Fagerström Test for Nicotine Dependence (Carpenter et al., 2010). Find the most appropriate nursing diagnosis for the patient, such as risk-prone health behavior. Use motivational interview techniques to promote the patient to self-assess their willingness and readiness to quit e-cigarettes (Hettema et al., 2005). Therapeutically communicate with the patient. Hold your judgment or personal beliefs about the situation because you are their biggest advocate and ally right now. Offer them interventions to help them successfully quit e-cigarettes. Start with less invasive options: avoid triggers such as people or situations; distract yourself with a hobby or task; talk to someone who has experienced what you’re currently experiencing; or call the substance abuse helpline (Mayo Clinic Staff, 2016; Malucky, 2010; Substance Abuse and Mental Health Services Administration, 2019). We can also talk to the provider and ask for medication to help with the withdrawal process. Medication may help manage symptoms like anxiety or depression. All these options give patients the freedom to choose how they want to
December 2021 Ohio Nurse Page 15 quit. They feel in control after a time where they felt e-cigarettes controlled their life. We spend the most time with these patients. We are the first line of defense for identifying and intervening in an e-cigarette user’s habits. We must uphold that nurse-patient trust and advocate for our patients’ health. The more we educate ourselves about e-cigarettes and inform our patients, the more promising outcomes for e-cigarette cessation in the future, like decreasing e-cigarette popularity and increasing health awareness and promotion. *Eligibility criteria included that participant must have been: an ASU student, at least 18 years old, and “current” e-cigarette user. Michelle Corerra, BSN, RN, is a nurse with HonorHealth’s COVID-19/Stroke Unit. Kong, G., Morean, M. E., Cavallo, D. A., Camenga, D. R., & Krishnan-Sarin, S. (2015). Reasons for electronic cigarette experimentation and discontinuation among adolescent and young adults. Nicotine and Tobacco Research, 17(7), 847-854. https://doi-org. ezproxy1.lib.asu.edu/10.1093/ntr/ntu257 Mayo Clinic Staff. (2016). Quitting smoking: 10 ways to resist tobacco cravings. Retrieved from https://www. mayoclinic.org/healthy-lifestyle/quit-smoking/indepth/nicotine-craving/art-20045454 Malucky, A. (2010). Brief evidence-based interventions for nurse practitioners to aid patients in smoking cessation. The Journal for Nurse Practitioners, 6(2), 126-131. https://doi-org.ezproxy1.lib.asu. edu/10.1016/j.nurpra.2009.05.017 National Cancer Institute. (n.d.). NCI dictionary of cancer terms. Retrieved from https://www.cancer.gov/ publications/dictionaries/cancer-terms/def/electroniccigarette Pattinson, J., Lewis, S., Bains, M., Britton, J., & Langley, T. (2018). Vape shops: Who uses them and what do they do? BMC Public Health, 18, 541. https://doi. org/10.1186/s12889-018-5467-9 Substance Abuse and Mental Health Services Administration. (2019). National helpline. Retrieved from https://www.samhsa.gov/find-help/nationalhelpline U.S. Department of Health and Human Services. (2016). E-cigarette use among youth and young adults: A report of the surgeon general [PDF file]. Retrieved from https://www.cdc.gov/tobacco/data_ statistics/sgr/e-cigarettes/pdfs/2016_sgr_entire_ report_508.pdf References Carpenter, M. J., Baker, N. L., Gray, K. M., & Upadhyaya, H. P. (2010). Assessment of nicotine dependence among adolescent and young adult smokers: A comparison of measures. Addictive Behaviors, 35(11), 977-982. https://doi-org.ezproxy1.lib.asu. edu/10.1016/j.addbeh.2010.06.013 Centers for Disease Control and Prevention. (2014). More than a quarter-million youth who had never smoked a cigarette used e-cigarettes in 2013. Retrieved from https://www.cdc.gov/media/releases/2014/p0825-ecigarettes.html Gorukanti, A., Delucchi, K., Ling, P., Fisher-Travis, R. & Halpern-Felsher, B. (2017). Adolescents’ attitudes towards e-cigarette ingredients, safety, addictive properties, social norms, and regulation. Preventive Medicine, 94, 65-71. https://doi-org.ezproxy1.lib.asu. edu/10.1016/j.ypmed.2016.10.019 Hettema, J., Steele, J., & Miller, W. R. (2005). Motivational interviewing. Annual Review of Clinical Psychology, 1, 91- 111. https://doi.org/10.1146/annurev.clinpsy.1.102803.143833 NursingALD.com can point you right to that perfect NURSING JOB! NursingALD.com Free to Nurses Privacy Assured Easy to Use E-mailed Job Leads Beavercreek Health and Rehab is looking for FT/PT Nurses-Days/Nights FT/PT STNA’s-Days and Nights Weekend Warrior positions available Great incentives! Sign on bonuses & Pick up bonuses New Pay Scale! Daily Pay Available! Apply on indeed.com or call Toni at (937)429-9655 to schedule an interview Available positions: We currently have full time, part time and per diem nursing positions available. $15k bonus with 3 year commitment We offer competitive pay and benefits including medical, dental, vision, PTO, 401k, tuition reimbursement and more! Contact Human Resources at (330) 386-2022 or apply online at www.elch.org/careers
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Ohio Nurse December 2021

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