Electronic Cigarette Use Prevalence, Associated Factors, and Pattern by Cigarette Smoking Status in the United States From NHANES (National Health and Nutrition Examination Survey) 2013-2014.

BACKGROUND: To examine the prevalence and patterns of recent electronic cigarette (e-cigarette) use in a nationally representative sample of US adults and adolescents. METHODS AND RESULTS: Using tobacco information from NHANES (National Health and Nutrition Examination Survey) 2013-2014, 5423 adults and 895 adolescents (aged 13-17 years) were included in this analysis. Demographic, tobacco use, and drug use information were self-reported. Recent e-cigarette use (within the previous 5 days) was stratified by smoking status. Of 125 e-cigarette users, 116 participants were aged ≥18 years, corresponding to 2.6% (95% confidence interval [CI], 2.0-3.1) and 1.21% (95% CI, 0.3-2.1) prevalence of e-cigarette use among US adults and adolescents, respectively. E-cigarette adult users were current smokers (68.1%), former smokers (23.7%), and never smokers (8.2%). The highest prevalence of e-cigarette use was among current smokers (8.2%; 95% CI, 6.3-10.1), followed by former smokers (2.7%; 95% CI, 1.4-4.1), and then never smokers (0.4%; 95% CI, 0.2-0.6). After adjusting for age, sex, and ethnicity, e-cigarette users had higher odds of being exposed to secondhand smoke (odds ratio: 6.3; 95% CI, 3.6-11.1) and drinking alcohol (odds ratio: 4.2; 95% CI, 1.8-10.0) and lower odds of having at least a college education or a higher income, compared with tobacco nonusers. CONCLUSIONS: Between 2013 and 2014, e-cigarette use in the United States was more common among younger people, those with low socioeconomic status, and current and former smokers. These findings will help inform future research as well as public policy and regulatory actions.

Patient satisfaction with primary health care services in Riyadh.

OBJECTIVE: To assess the level of patients' satisfaction with primary health care PHC services in health centers affiliated to Riyadh Military Hospital RMH, Riyadh, Kingdom of Saudi Arabia. METHODS: A cross-sectional study was conducted in 3 PHC centers, affiliated to Riyadh Military Hospital RMH, Riyadh, Kingdom of Saudi Arabia, over 2 months period in 2006, data was collected using a self-administered questionnaire to assess patients' overall satisfaction with PHC services and their level of satisfaction with 5 PHC domains: reception services, accessibility, continuity of care, communication, and enablement. RESULTS: Seven hundred questionnaires were distributed yielding 86.6% response rate, 39.6% of our patients were 20-30 years old, 51.5% of the respondents were females, 76.4% were married and 34.5% of them showed a medical visit frequency of a minimum of 8 times per year. The domains of PHC with the highest level of reported satisfaction was enablement (70.6%). The poorest level of satisfaction was at the continuity of care (56.3%). The mean score of satisfaction with reception was 70.0%, communication 69.2%, and accessibility to care was 62.4%. The overall satisfaction level was 64.2%. Patients of older age were more satisfied with PHC services than their younger counterparts (p-value<0.001) and patients with lower education level were more satisfied (p-value<0.001). Patients' satisfaction was inversely related to their average annual visit frequency to PHC centers (p-value =0.015). There was no relation found between patients' satisfaction and their gender, marital status, occupational status, and their average monthly income. CONCLUSION: The level of satisfaction with PHC services in health centers affiliated to RMH is relatively low, results identified areas in which quality improvement is required, mainly accessibility and continuity of care.