Clinical Edge

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Does E-cigarette Use Promote Smoking Cessation?

BMJ; ePub 2017 Jul 26; Zhu, Zhuang, et al

The substantial increase in e-cigarette use among US adult smokers is associated with a statistically significant increase in the smoking cessation rate, a recent study found. Data from population surveys with nationally representative samples were analyzed. Data on e-cigarette use were obtained from the total sample of the 2014-15 US Current Population Survey-Tobacco Use Supplement (CPS-TUS). Rates from the 2014-2015 CPS-TUS were compared with those from the 2010-2011 CPS-TUS and those from 3 other previous surveys. Outcomes included the rate of attempt to quit cigarette smoking and the rate of successfully quitting smoking, defined as having quit smoking for at least 3 months. Researchers found:

  • Of 161,054 respondents to the 2014-2015 survey, 22,548 were current smokers and 2,136 recent quitters.
  • E-cigarette users were more likely than nonusers to attempt to quit smoking and more likely to succeed in quitting.
  • The overall rate of smoking cessation for the US population was significantly higher in 2014-2015 than in 2010-2011, as well as than in all previous survey years.

Citation:

Zhu SH, Zhuang YL, Wong S, Cummins SE, Tedeschi GJ. E-cigarette use and associated changes in population smoking cessation: Evidence from US current population surveys. [Published online ahead of print July 26, 2017]. BMJ. doi:10.1136/bmj.j3262.

Commentary:

This study, conducted at a population level, is consistent with the results of a recent Cochrane review suggesting that e-cigarettes can help with smoking cessation.1 However, many people who use e-cigarettes do not use them for smoking cessation, but rather as a primary nicotine delivery device. This is particularly true with adolescent use of e-cigarettes. In 2015, e-cigarettes became the most commonly used tobacco product among middle school (5.3%) and high school (16.0%) students, and they appear to lead to a greater liklihood of progressing to smoking regular tobacco products.2,3 Whether e-cigarettes are helpful or harmful at a population level remains to be seen. While they do appear to be helpful for tobacco cessation, because they containn nicotein, their use for people who do not currently smoke cigarettes should be discouraged. —Neil Skolnik, MD

  1. Hartmann-Boyce J, McRobbie H, Bullen C, Begh R, Stead LF, Hajek P. Electronic cigarettes for smoking cessation. [Published online ahead of print September 14, 2016]. Cochrane Database System Rev. doi:10.1002/14651858.CD010216.pub3.
  2. Singh T, Arrazola RA, Corey CG, et al. Tobacco use among middle and high school students—United States, 2011–2015. [Published online ahead of print April 15, 2016]. MMWR Morb Mortal Wkly Rep. 2016;65:361–367. doi:10.15585/mmwr.mm6514a1.
  3. Leventhal AM, Strong DR, Kirkpatrick, et al. Association of electronic cigarette use with initiation of combustible tobacco product smoking in early adolescence. JAMA. 2015;314(7):700-707. doi:10.1001/jama.2015.8950.