Investigating the Relation between Electronic Cigarette Use and Sleep Duration in Kentucky Using the BRFSS, 2016-2017

Objectives Like traditional cigarettes, electronic cigarettes (e-cigarettes) contain nicotine, which is known to negatively influence sleep quality. Few studies, however, have examined the relation between e-cigarettes and sleep quality using population-based survey data because of the relatively recent appearance of these products on the market. This study investigated the relation between e-cigarette and cigarette use and sleep duration in Kentucky, a state with high rates of nicotine dependence and related chronic diseases. Methods Data from two consecutive years of the Behavioral Risk Factor Surveillance System survey - 2016 and 2017 - were analyzed using χ2 statistics and multivariable Poisson regression analyses to control for socioeconomic and demographic variables, the presence of other chronic diseases, and traditional cigarette use. Results This study was conducted using responses from 18,907 Kentucky adults aged 18 years and older. Overall, almost 40% reported short (<7 hours) sleep duration. After adjusting for other covariates, including the presence of chronic diseases, those who had currently or formerly used both traditional and e-cigarettes had the highest risk of short sleep duration. Those who currently or formerly smoked only traditional cigarettes also had significantly higher risk, unlike those who had only used e-cigarettes. Conclusions Survey respondents who used e-cigarettes were more likely to report short sleep duration, but only if they currently or formerly smoked traditional cigarettes. Those who used both products, regardless of whether current or former, were more likely to report short sleep duration than those who had used just one of these tobacco products.