{
  "abstract": "Introduction: A Korean National Health Insurance Service (NHIS) cohort study reported higher lung cancer incidence among former smokers who used e-cigarettes after quitting than among those who quit without them. Interpreting that association requires knowing which product was used and how long ago participants quit; the cohort measured neither directly, but the contemporaneous Korea National Health and Nutrition Examination Survey (KNHANES) did.\n\nMethods: KNHANES 2018, a cross-sectional national survey, used the NHIS umbrella e-cigarette term, a separate heated tobacco product (HTP) item, and months since cessation. Former smokers using either product (n = 43) were compared with those using neither (n = 1,305), with replication in 2019–2023.\n\nResults: Of adults affirming current umbrella e-cigarette use, 64% also reported HTP use (former smokers, 50%); 79% of product-using former smokers reported HTP use. Median time since cessation was eight months among product users and twelve years among others (Kolmogorov–Smirnov D = 0.76, P < 0.001). The gap was replicated in every wave through 2023 (D = 0.63–0.76) and persisted in the long-term quitter stratum (pooled 2019–2023 medians, 6 vs 18 years), in Kim et al.’s high-risk subgroup (2 vs 12 years), after age matching (residual 9.0–11.0 years) and among umbrella-item respondents only (D = 0.73).\n\nConclusions: The reported association is consistent with residual confounding by cessation timing and with product misclassification. It also rests on few exposed events: 16 in the long-term stratum, and 31 of 71 retained when exposure was updated at the next screening. Because at most half of the exposure was exclusive liquid e-cigarette use, an e-cigarette-specific estimate would need about four times as many exposed events for the same precision. Repeated-screening designs that update cessation and product use at every screening, already used for cessation in the same database, would retain the full sample and allow more precise, product-specific dose-response estimates.",
  "abstract_shown": true,
  "affiliations": [],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 3,
  "authors": [
    {
      "name": "S Cook"
    },
    {
      "name": "G Cohen",
      "orcid": "0000-0002-4367-1491"
    },
    {
      "name": "KM Cummings",
      "orcid": "0000-0002-7103-7017"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/ct00214ck2nja.bib",
  "cited_by": 0,
  "doi": "10.64898/2026.08.11.26360188",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13640878/",
  "id": "ct00214ck2nja",
  "issns": [],
  "landing_url": "https://doi.org/10.64898/2026.08.11.26360188",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Article"
    ],
    [
      "medrxiv",
      "oncology"
    ],
    [
      "openalex",
      "2737|Smoking Behavior and Cessation"
    ]
  ],
  "openalex": "W7202344009",
  "pdf_url": "https://www.medrxiv.org/content/10.64898/2026.08.11.26360188v2.full.pdf",
  "pmcid": "PMC13640878",
  "pmid": "42845679",
  "published": "2026-08-11",
  "publisher": "Cold Spring Harbor Laboratory Preprints",
  "ris": "https://research.draconitic.com/paper/ct00214ck2nja.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:30Z",
      "native_id": "PMC13640878",
      "source": "pmc",
      "url": "https://doi.org/10.64898/2026.08.11.26360188"
    },
    {
      "first_seen": "2026-10-30T12:21:21Z",
      "native_id": "10.64898/2026.08.11.26360188",
      "source": "medrxiv",
      "url": "https://www.medrxiv.org/content/10.64898/2026.08.11.26360188v2"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "medrxiv:oncology",
      "subfield": "oncology"
    }
  ],
  "title": "Brief Report: An Eleven-Year Cessation Gap among Korean Former Smokers using Heated Tobacco or E-Cigarettes: Implications for Lung Cancer Risk Estimates",
  "title_text": "Brief Report: An Eleven-Year Cessation Gap among Korean Former Smokers using Heated Tobacco or E-Cigarettes: Implications for Lung Cancer Risk Estimates",
  "type": "preprint",
  "updated_at": "2026-10-30T12:33:29Z",
  "url": "https://research.draconitic.com/paper/ct00214ck2nja",
  "venue": "medRxiv",
  "versions": []
}