Among US adults who were established smokers in the past five years, those who use e-cigarettes daily were significantly more likely to have quit cigarettes compared to those who have never tried e-cigarettes, found a Columbia University study.
Researchers at Columbia University's Mailman School of Public Health and the Rutgers School of Public Health found that over half of daily e-cigarette users had quit smoking in the past five years, compared to just 28% of adults who had never tried e-cigarettes. This is one of the first studies to reveal the patterns of cessation prevalence among e-cigarette users at a national level.
After accounting for participants' desire to quit smoking cigarettes and controlling for other factors known to predict quitting such as educational attainment, health insurance, and age, the probably of having quit was three times higher among daily e-cigarette users compared to never e-cigarette users.
"While questions regarding the efficacy of e-cigarettes for smoking cessation remain, our findings suggest that frequent e-cigarette use may play an important role in cessation or relapse prevention for some smokers," said Dr Daniel Giovenco, assistant professor of socio-medical sciences at the Mailman School of Public Health, and lead author.
The researchers used data from the 2014 and 2015 National Health Interview Survey, an annual, cross-sectional household interview survey, and restricted the sample to current smokers and former smokers who quit in 2010 or later. This year marked the rapid rise in the popularity of e-cigarettes and their US market entry. The researchers found the single strongest predictor of having quit was daily e-cigarette use. Smokers who were only occasional users of e-cigarettes were less likely to quit smoking cigarettes.
"Without knowing details about device attributes, user experiences, and motivations for e-cigarette use, reasons for low cessation rates among infrequent e-cigarette users are unclear," suggested Dr Cristine Delnevo, the study's second author and vice dean of the Rutgers School of Public Health, who joins her co-author in underscoring the need for improved e-cigarette survey measures that assess this critical information.
Giovenco adds, "The US Food and Drug Administration (FDA) recently delayed rules that would have limited e-cigarettes on the market. This indicates that public health officials may be receptive to innovative and lower-risk nicotine products. Uncovering patterns of use at the population level is a critical first step in determining if they may present any benefits to public health."
Introduction: Amid decreasing rates of cigarette smoking and a rise in e-cigarette use, there is a need to understand population patterns of use to inform tobacco control efforts and evaluate whether e-cigarettes may play a role in tobacco harm reduction. Methods: This study merged data from the 2014 and 2015 National Health Interview Survey (NHIS) and restricted the sample to recent smokers [i.e., current smokers and former smokers who quit in 2010 or later (n=15,532)]. Log-binomial regression estimated adjusted prevalence ratios (aPR) for being quit by e-cigarette use status (i.e., daily, some day, former trier, never). All analyses controlled for factors traditionally correlated with smoking cessation. Results: A quarter of the sample (25.2%) were former smokers. The prevalence of being quit was significantly higher among daily e-cigarette users compared to those who had never used e-cigarettes [52.2% vs. 28.2%, aPR: 3.15 (2.66, 3.73)]. Those who used e-cigarettes on some days were least likely to be former smokers (12.1%). These relationships held even after accounting for making a quit attempt and use of other tobacco products. Conclusions: Among those with a recent history of smoking, daily e-cigarette use was the strongest correlate of being quit at the time of the survey, suggesting that some smokers may have quit with frequent e-cigarette use or are using the products regularly to prevent smoking relapse. However, the low prevalence of cessation among infrequent e-cigarette users highlights the need to better understand this subgroup, including the individual factors and/or product characteristics that may inhibit cessation.
Daniel P Giovenco, Cristine D Delnevo
[link url="https://www.mailman.columbia.edu/public-health-now/news/daily-e-cigarette-users-had-highest-rates-quitting-smoking"]Columbia University Mailman School of Public Health material[/link]
[link url="https://www.researchgate.net/publication/318891784_Prevalence_of_population_smoking_cessation_by_electronic_cigarette_use_status_in_a_national_sample_of_recent_smokers"]Addictive Behaviours abstract[/link]