BACKGROUND: Understanding the population impact of e-cigarettes requires determining their effect on cigarette smoking cessation.
METHODS: Using the U.S. Population Assessment of Tobacco and Health (PATH) cohort, we examined smoking cessation among adult current cigarette smokers at Wave 1 with follow-up data at Waves 2 and 3 (n=9,724).
RESULTS: By Wave 3 (2015/2016), 17.3% of smokers had quit smoking. Smokers using e-cigarettes daily or who increased to daily use over the 3 waves were 2-4 times more likely to have quit in the short (<1 year) and long-term (1+ years) compared with never e-cigarette users (p<0.001). E-cigarette use in the last quit attempt was associated with a higher likelihood of short-term (<1 year) quitting at Wave 3 (aRRR:1.33; 95% CI:1.04,1.71) compared with smokers who did not use an e-cigarette in their last quit attempt. Non-current (no use in any wave) e-cigarette users and users who were unstable in use frequency were 33% and 47% less likely to quit in the short-term, respectively (p<0.001). Flavored (vs. non-flavored) and using a rechargeable (vs. disposable) e-cigarette device was associated with an increased likelihood of both short- and long-term quitting.
CONCLUSION: Smoking cessation was more likely among frequent e-cigarette users, users of e-cigarettes in last quit attempt, and users of flavored and rechargeable devices. Less frequent, unstable, past or never e-cigarette users were less likely to quit smoking. Monitoring the relationship between patterns of e-cigarette and cigarette use is complex but critical for gauging the potential of e-cigarettes as a harm reduction tool.
IMPLICATIONS: This study suggests that consistent and frequent e-cigarette use over time is associated with cigarette smoking cessation among adults in the US. In addition, findings suggest that flavored e-cigarette use and use of rechargeable e-cigarette devices can facilitate smoking cessation. These results underscore the importance of carefully defining and characterizing e-cigarette exposure patterns, potential confounders, and use of e-cigarettes to quit smoking, as well as variations in length of the smoking cessation.
Patterns of e-cigarette use and subsequent cigarette smoking cessation over two years (2013/2014 to 2015/2016) in the Population Assessment of Tobacco and Health (PATH) Study
Nicotine and Tobacco Research, 23 (4), 669-677. doi: 10.1093/ntr/ntaa182. PMCID: PMC7976933.