BACKGROUND: Nicotine product use (NPU) is changing rapidly worldwide but relatively little is known about how this may be associated with intentions and attempts to quit tobacco use. This study addresses this gap.
METHODS: This study is a longitudinal analysis of seven waves of the nationally representative Healthy Ireland (HI) cross-sectional survey conducted between 2015 and 2023 (N=52,167). Survey-weighted prevalence of current tobacco use, e-cigarette use, and dual use of tobacco and e-cigarettes was estimated for each wave separately. Associations between sociodemographic factors and NPU, as well as between NPU and quit intentions and attempts, respectively, were examined using survey-weighted regression models in 2015 (N=7,502) and 2023 (N=7,356) waves.
RESULTS: Between 2015 and 2023, current tobacco use declined from 22.8% to 17.7% (p=0.012), e-cigarette use rose from 3.1% to 8.4% (p=0.001) and dual use from 1.3% to 3.1% (p=0.006), overall. The most pronounced increases were observed among those aged 15–24, where e-cigarette rose from 0.9% to 17.7% and dual use from 0.3% to 6.9%. In 2015, dual use was strongly associated with higher quit intentions, relative to tobacco-only users, but this was no longer the case in 2023. Similarly, in 2015 dual use was associated with past-year quit attempts relative to tobacco-only users (aOR 3.3, 95% CI 2.0–5.4) but by 2023, this association was no longer apparent (aOR 1.2, 95% CI 0.8–1.7).
CONCLUSIONS: Over the study period, e-cigarette and dual use more than doubled, while associations between dual use and quit intentions and attempts attenuated. These findings underscore the need for a robust regulatory framework for e-cigarettes and a renewed focus on advancing tobacco control.