Study provides “strong case” that e-cigarette use helps smoking cessation

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A US study based on the largest representative sample of e-cigarette users to date has provided evidence that e-cigarette use is associated with an increase in smoking cessation at the population level.

Published online in the British Medical Journal, Shu-Hong Zhu (San Diego, USA) and colleagues conclude, “This is the first statistically significant increase observed in population smoking cessation among US adults in nearly a quarter of a century. These findings need to be weighed carefully in regulatory policy making and in the planning of tobacco control interventions.”

Current regulatory policies on electronic cigarettes vary “widely” across countries, Zhu and colleagues note, and the scientific community is similarly divided on its opinion of e-cigarettes as smoking cessation aides. Zhu et al argue that rather than the potential efficacy of e-cigarettes for individual users, the real debate is about the overall population impact.

This investigation examined the relation between e-cigarette use and smoking cessation in the US population using the largest representative sample of smokers and e-cigarette users available to date; the 2014–15 Current Population Survey-Tobacco Use Supplement (CPS-TUS). The CPS-TUS is a periodic tobacco survey attached to the Current Population Survey and administered by the US Census Bureau It provides data from a nationally-representative sample of US households of non-institutionalised civilians.

Current smokers were defined as having smoked at least 100 cigarettes in their lifetime and smoking every day or some days at the time of interview. A attempt to quit was defined as having tried to quit smoking and achieving it for at least 24 hours. The “cessation rate” was the percentage of those who had quit for at least three months at the time of the interview among those who were smoking 12 months before the interview.

Of 161,054 respondents to the 2014–15 survey, 22,548 were current smokers and 2,136 recent quitters. Among them, 38.2% of current smokers and 49.3% of recent quitters had tried e-cigarettes, and 11.5% and 19% used them currently (every day or some days). E-cigarette users were more likely than non-users to attempt to quit smoking, 65.1% vs. 40.1% (25% change, 95% confidence interval 23.2–26.9%), and more likely to succeed in quitting, 8.2% vs. 4.8% (3.5% change, CI 2.5–4.5%). The overall population cessation rate for 2014–15 was significantly higher than that for 2010–11, 5.6% vs. 4.5% (1.1% change, CI 0.6–1.5%), and higher than those for all other survey years (range 4.3–4.5%).

“This study has two principal findings,” the authors explain. “First, in 2014–15, e-cigarette users in the USA attempted to quit cigarette smoking and succeeded in quitting at higher rates than non-users. Second, the overall population smoking cessation rate in 2014–15 increased statistically significantly from that in 2010–11. The 1.1% increase in cessation rate (from 4.5% to 5.6%) might appear small, but it represents approximately 350,000 additional US smokers who quit smoking in 2014–15.”

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