Association of cancer information seeking behavior with cigarette smoking and E-cigarette use among U.S. adults by education attainment level: A multi-year cross-sectional analysis from a nationally representative sample in 2017-2020.

Abstract

Little is known about the association of cancer information seeking behavior with cigarette smoking and e-cigarette use. A multi-year cross-sectional analysis using a pooled data of the Health Information National Trends Survey 5, Cycles 1-4 (2017-2020) was conducted. To examine the association of cancer information seeking behavior with current cigarette smoking (currently smoke every day/some days among individuals who smoked 100+ cigarettes in lifetime) and e-cigarette use (currently use every day/some days among lifetime users) in nationally representative U.S. adults, we conducted weighted multiple logistic regression analysis, adjusting for sex, race/ethnicity, age, obese status, depressed mood, cancer diagnosis history, metropolitan status, and survey year. The regression models were stratified by education level (<college and ≥ college). Individuals in 18-25 years old were excluded as they have not likely completed their education. A final analytic sample included 12,430 adults. Cancer information seekers had lower odds of cigarette smoking than non-seekers, but this was observed in only ≥college group (Adjusted odds ratio [AOR] = 0.78, 95% confidence interval [CI] = 0.61, 0.99). Conversely, cancer information seekers had higher odds of e-cigarette use than non-seekers, but this was significant in only <college group (AOR = 2.12, 95% CI = 1.18, 3.83). Cancer information seeking behavior might help to reduce cigarette smoking when seekers had ≥college education. However, cancer information seeking behavior might positively influence e-cigarette use in <college group. A proper/easy-to-understand dissemination of proven cancer information regarding cigarette smoking and e-cigarette use considering the unproven cancer risk of e-cigarette use is recommended for less educated individuals.