Analysis of the Dual Use of Electronic Cigarettes and Conventional Tobacco According to the Survey on Alcohol and Other Drugs in the General Population in Spain (EDADES 2022)

Introduction: Electronic nicotine delivery systems may lead to challenges for public health. This study described the use of electronic cigarettes (EC) and dual consumption in the Spanish population. Material and Methods: Descriptive cross-sectional study of the 2022 Survey on Alcohol and Other Drugs in the General Population in Spain (EDADES), aged 15-64. Variables: sociodemographic, dual consumption (EC and conventional tobacco, daily and/or within the last 30 days), and perceived health status. Analysis: descriptive, multinomial logistic regression. Results: 26,337 participants, (51% men). The prevalence of dual consumers in the population was 1.55% (95%CI: 1.40-1.70). For every year increase in age, the likelihood of being an exclusive tobacco smoker increased with an OR:1.04, (IC95%:1.03-1.05). Having an income between 1,000-1,499€ and 1,500-2,499€ associated exclusive tobacco versus dual use, OR 1.52 (95% CI:1.01-2.27) and 1.92 (95% CI:1.30-2.84), respectively. Dual use associated a ‘fair’ perceived health status compared to exclusive EC users (OR:0.26; 95%CI:0.12–0.57) and exclusive conventional tobacco (OR:0.60; 95%CI:0.45–0.80), and a ‘poor/very poor’ health status compared to exclusive tobacco (OR:0.42; 95%CI:0.23–0.77). Among former EC smokers, 71% now smoked conventional tobacco exclusively. Conclusion: The prevalence of dual consumers in Spain was 1.55%. Smoking EC might lead to an increase of tobacco smokers.