Abstract
BackgroundMost smokers attempting to quit relapse. There is little evidence whether the use of e-cigarettes (‘vaping’) increases or decreases relapse. This study aimed to assess 1) whether vaping predicted relapse among ex-smokers, and 2) among ex-smokers who vaped, whether vaping characteristics predicted relapse.MethodsLongitudinal web-based survey of smokers, recent ex-smokers and vapers in the UK, baseline in May/June 2016 (n = 3334), follow-up in September 2017 (n = 1720). Those abstinent from smoking ≥ 2 months at baseline and followed up were included. Aim 1: Relapse during follow-up was regressed onto baseline vaping status, age, gender, income, nicotine replacement therapy use and time quit smoking (n = 374). Aim 2: Relapse was regressed onto baseline vaping frequency, device type, nicotine strength and time quit smoking (n = 159).ResultsOverall, 39.6% relapsed. Compared with never use (35.9%), past/ever (45.9%; adjOR = 1.13; 95% CI, 0.61–2.07) and daily vaping (34.5%; adjOR = 0.61; 95% CI, 0.61–1.89) had similar odds of relapse, for non-daily vaping evidence of increased relapse was inconclusive (65.0%; adjOR = 2.45; 95% CI, 0.85–7.08). Among vapers, non-daily vaping was associated with higher relapse than daily vaping (adjOR = 3.88; 95% CI, 1.10–13.62). Compared with modular devices (18.9% relapse), tank models (45.6%; adjOR = 3.63; 95% CI, 1.33–9.95) were associated with increased relapse; evidence was unclear for disposable/cartridge refillable devices (41.9%; adjOR = 2.83; 95% CI, 0.90–8.95). Nicotine strength had no clear association with relapse.ConclusionRelapse to smoking is likely to be more common among ex-smokers vaping infrequently or using less advanced devices. Research into the effects of vaping on relapse needs to consider vaping characteristics.
Highlights
Smoking remains the primary preventable cause of illness and premature death in countries with a high sociodemographic index such as the United Kingdom (UK) [1]
Participants were recruited through Ipsos MORI, a leading market research organisation in the UK, from members of an online panel managed by Ipsos Interactive Services
Attrition and sample characteristics While follow-up rates were low from wave 4 to wave 5 (51.6%), follow-up for ex-smokers at wave 4 showed very little variation by time since they had quit smoking, vaping status, nicotine replacement therapy (NRT) use, gender or income; only age differed between groups with those followed up on average older than those lost to follow-up (Additional file 1: Table S1 for details)
Summary
Smoking remains the primary preventable cause of illness and premature death in countries with a high sociodemographic index such as the United Kingdom (UK) [1]. Population surveys from the USA, UK, Canada and Australia show that at least a third of smokers have made a serious attempt to quit smoking in the past year [2, 3]. Less than 5% are still abstinent 1 year after they made a quit attempt [4]. A recent review and modelling study showed that after 12 weeks of licenced pharmacotherapy, abstinence rates at 1 year were 23% for varenicline, the most effective treatment, 17% for bupropion, 13% for nicotine replacement therapy (NRT). There is little evidence on effective interventions to reduce relapse with evidence of a benefit available only for varenicline [6]. This study aimed to assess 1) whether vaping predicted relapse among exsmokers, and 2) among ex-smokers who vaped, whether vaping characteristics predicted relapse
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