Is the use of electronic cigarettes while smoking associated with smoking cessation attempts, cessation and reduced cigarette consumption? A survey with a 1‐year follow‐up

Abstract

AimsTo use a unique longitudinal data set to assess the association between e‐cigarette use while smoking with smoking cessation attempts, cessation and substantial reduction, taking into account frequency of use and key potential confounders.DesignWeb‐based survey, baseline November/December 2012, 1‐year follow‐up in December 2013.SettingGreat Britain.ParticipantsNational general population sample of 4064 adult smokers, with 1759 (43%) followed‐up.MeasurementsMain outcome measures were cessation attempt, cessation and substantial reduction (≥50% from baseline to follow‐up) of cigarettes per day (CPD). In logistic regression models, cessation attempt in the last year (analysis n = 1473) and smoking status (n = 1656) at follow‐up were regressed on to baseline e‐cigarette use (none, non‐daily, daily) while adjusting for baseline socio‐demographics, dependence and nicotine replacement (NRT) use. Substantial reduction (n = 1042) was regressed on to follow‐up e‐cigarette use while adjusting for baseline socio‐demographics and dependence and follow‐up NRT use.FindingsCompared with non‐use, daily e‐cigarette use at baseline was associated with increased cessation attempts [odds ratio (OR) = 2.11, 95% confidence interval (CI) = 1.24–3.58, P = 0.006], but not with cessation at follow‐up (OR = 0.62, 95% CI = 0.28–1.37, P = 0.24). Non‐daily use was not associated with cessation attempts or cessation. Daily e‐cigarette use at follow‐up was associated with increased odds of substantial reduction (OR = 2.49, 95% CI = 1.14–5.45, P = 0.02), non‐daily use was not.ConclusionsDaily use of e‐cigarettes while smoking appears to be associated with subsequent increases in rates of attempting to stop smoking and reducing smoking, but not with smoking cessation. Non‐daily use of e‐cigarettes while smoking does not appear to be associated with cessation attempts, cessation or reduced smoking.

The Relation between Frequency of E-Cigarette Use and Frequency and Intensity of Cigarette Smoking among South Korean Adolescents

“…This finding is plausible because even heavier adolescent smokers tend to be more nicotine-dependent [25] and would use e-cigarettes more heavily. It has been suggested that intensive or daily use of e-cigarettes, especially the tank type, may increase the chances of quitting smoking among adults [14,15]; however, no cessation aid, including e-cigarettes, has proved to be effective among adolescents [26]. Moreover, considering the potential adverse effect of nicotine on adolescent brain development [27], heavier e-cigarette use would likely cause more potential harm than benefit among adolescents.…”

“…It is important to distinguish established users from non-established users because there is a difference in the reason for e-cigarette initiation in addition to the extent of its use [13]. According to previous studies considering current cigarette smokers, the successful smoking cessation rate was higher among daily or intensive e-cigarette users compared with nondaily or intermittent users [14][15][16]. 2 of 8 The general concept of current e-cigarette use is broadly defined to differentiate experimenters from regular users.…”

Ethical imperatives assuming ENDS effectiveness and safety are fragile

“…The same study [9] found daily ENDS users reduced daily smoking frequency significantly, but four cohort studies [11][12][13] have now reported that even 50% reductions do not confer either any or significant risk reductions compared to smoking cessation. Dual use, far more common in daily vapers than exclusive ENDS use, is not harm-reducing; so, again, high-minded ethical exhortations about reducing harm remain questionable.…”

“…All have been criticized for including non-daily users in their analyses, but the most recent study which separated daily from non-daily users also found no statistically significantly differences between daily, less than daily and non-vaping smokers for smoking cessation [9]. A sub-analysis found that daily 'tank' vapers were more likely to quit, although nearly three quarters of these were still dual using at 12 months and the proportions of smokers involved were small [10].…”

“…All longitudinal studies of vaping have found cessation rates lower in ENDS users than non-users [9]. All have been criticized for including non-daily users in their analyses, but the most recent study which separated daily from non-daily users also found no statistically significantly differences between daily, less than daily and non-vaping smokers for smoking cessation [9].…”