Abstract
INTRODUCTION: Electronic nicotine delivery systems present emerging challenges for public health. This study describes the use of electronic cigarettes (ECs) and dual consumption patterns in the Spanish population. MATERIAL AND METHODS: A descriptive cross-sectional study was conducted using data from the 2022 Survey on Alcohol and Other Drugs in the General Population in Spain (EDADES), targeting individuals aged 15-64. Variables included sociodemographic characteristics, dual consumption (defined as use of both EC and conventional tobacco, daily and/or within the last 30 days), perceived health status, and self-perceived risk of ECs or tobacco consumption. Analysis included descriptive statistics and multinomial logistic regression. RESULTS: The study included 26,337 participants, (51% men). The prevalence of dual users in the population was 1.55% (95%CI: 1.40-1.70). Each additional year of age was associated with increased odds of exclusive tobacco use (aOR: 1.04; IC95%: 1.02-1.05). Compared to dual users, individuals with monthly incomes of 1000-1499 and 1500-2499 had higher odds of exclusive tobacco use (aOR 1.56; 95%CI: 1.03-2.34 and 1.90; 95%CI: 1.28-2.82, respectively). Dual use was associated with a 'fair' perceived health compared to exclusive EC users (aOR: 0.28; 95%CI: 0.13-0.60) and exclusive tobacco users (aOR: 0.62; 95%CI: 0.47-0.83), and with 'poor/very poor' health compared to exclusive tobacco users (OR: 0.43; 95%CI: 0.24-0.79). Among former EC users, 71% reported exclusive conventional tobacco use in the past 30 days. CONCLUSION: The prevalence of dual use in Spain was 1.55%. Dual users were younger than conventional tobacco smokers and, had lower income levels and poorer self-perceived health status compared to exclusive EC users.