E-cigarettes represent a novel method of nicotine inhalation that is growing in popularity and has been studied as a tool for smoking cessation in the general population; however their effect on disease activity, smoking cessation efficacy, disease course, and response to therapy in Inflammatory Bowel Disease (IBD) is unclear. This study attempts to better define and characterize e-cigarette (e-cig) use in the clinical context of patients with IBD. The specific aim of this project is to analyze the associated behavior and patterns of e-cigarette usage among patients with IBD.Methods:
E-cig users were identified from a retrospective database of smoking behaviors in an IBD population. A comprehensive phone questionnaire, addressing patterns of e-cigarette usage, was then administered by phone, in those who consented. A retrospective chart review was subsequently performed, with specific emphasis on IBD disease activity. Medical records were reviewed for clinical assessments of disease activity, medication changes, endoscopies, MREs, and surgeries during the year prior to beginning e-cig use, the period when e-cigs were used, and the year after e-cigs were stopped if applicable.Results:
Fourty-nine patients were identified for study inclusion. Among these, 27 consented to participate in the study. Baseline characteristics revealed no significant differences in age, gender, or disease subtype between current and former e-cig users. Current e-cig users, however were less likely to be current smokers (0% versus 50%, P = 0.0261). Current e-cig users tended to use e-cigs for a longer duration of time (34 versus 6 mo, P = 0.0355) with fewer times per day (6 versus 12.5) and a lower nicotine content (3 versus 11 mg/mL). Use of e-cigs was found to reduce cravings for regular cigarettes in 21 of 27 people but sustained smoking cessation was only seen in 17 of the 27. The primary motivation for choosing e-cigs over other methods of smoking cessation was that other methods were unsuccessful for the patient (74.29%), in addition to the appeal of the hand to mouth habit and resemblance to regular cigarettes afforded by the e-cigs (63.57%). Disease activity via subjective and objective measures were recorded but unable to be evaluated for significance due to a small sample size.Conclusions:
E-cig users experienced a lessened craving for regular cigarettes while using e-cigs but did not experience significance in sustained smoking remission. Limitations of the study included a small sample size and recall bias. However, this preliminary data offers insights into e-cigarette use in a vulnerable population. Understanding the impact on disease activity will allow for improved disease management as well as counseling on appropriate smoking cessation methods.