Abstract
Objectives To estimate how far changes in the prevalence of electronic cigarette (e-cigarette) use in England have been associated with changes in quit success, quit attempts, and use of licensed...
Highlights
There has been concern that the increase in population use of electronic cigarettes (e-cigarettes) could be undermining quitting activities.[1,2,3,4,5,6,7] If this is true, e-cigarettes could have a negative effect on public health, even if they might increase the chances of success for an individual smoker using them in a given quit attempt.[8 9]
This empirical study used a time series approach to estimate the population impact of e-cigarettes on attempts to quit smoking and their success, on the use of smoking cessation pharmacotherapy, and on the use of stop smoking services in England The study findings conflict with the hypothesis that an increase in population use of e-cigarettes undermines quitting, but it may have reduced the use of nicotine replacement therapy obtained on prescription and be positively associated with quit success e-cigarette use during a recent quit attempt, respectively
There was no clear evidence for an association between e-cigarette use and rate of quit attempts (β 0.025; 95% confidence interval −0.035 to 0.085; P=0.41), use of nicotine replacement therapy (NRT) bought over the counter (β 0.006; −0.088 to 0.077; P=0.89), use of prescription treatment (β −0.070; −0.152 to 0.013; P=0.10), or use of behavioural support (β −0.013; −0.102 to 0.077; P=0.78)
Summary
There has been concern that the increase in population use of electronic cigarettes (e-cigarettes) could be undermining quitting activities.[1,2,3,4,5,6,7] If this is true, e-cigarettes could have a negative effect on public health, even if they might increase the chances of success for an individual smoker using them in a given quit attempt.[8 9] England is a country with a relatively liberal regulatory framework for e-cigarettes and has seen a considerable growth in their use.[10 11] It has unique time series data to be able to estimate changes over time in key quitting activities as a function of changes in prevalence of e-cigarette use while adjusting for other potential confounding variables.[10 12] This study used data from England to address the concerns that have been raised. We found that the increase in population rates of e-cigarette use while smoking was probably not responsible for a decline in use of nicotine replacement therapy (NRT) for smoking reduction.[10]
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