Abstract
AimsTo use a unique longitudinal data set to assess the association between e‐cigarette use while smoking with smoking cessation attempts, cessation and substantial reduction, taking into account frequency of use and key potential confounders.DesignWeb‐based survey, baseline November/December 2012, 1‐year follow‐up in December 2013.SettingGreat Britain.ParticipantsNational general population sample of 4064 adult smokers, with 1759 (43%) followed‐up.MeasurementsMain outcome measures were cessation attempt, cessation and substantial reduction (≥50% from baseline to follow‐up) of cigarettes per day (CPD). In logistic regression models, cessation attempt in the last year (analysis n = 1473) and smoking status (n = 1656) at follow‐up were regressed on to baseline e‐cigarette use (none, non‐daily, daily) while adjusting for baseline socio‐demographics, dependence and nicotine replacement (NRT) use. Substantial reduction (n = 1042) was regressed on to follow‐up e‐cigarette use while adjusting for baseline socio‐demographics and dependence and follow‐up NRT use.FindingsCompared with non‐use, daily e‐cigarette use at baseline was associated with increased cessation attempts [odds ratio (OR) = 2.11, 95% confidence interval (CI) = 1.24–3.58, P = 0.006], but not with cessation at follow‐up (OR = 0.62, 95% CI = 0.28–1.37, P = 0.24). Non‐daily use was not associated with cessation attempts or cessation. Daily e‐cigarette use at follow‐up was associated with increased odds of substantial reduction (OR = 2.49, 95% CI = 1.14–5.45, P = 0.02), non‐daily use was not.ConclusionsDaily use of e‐cigarettes while smoking appears to be associated with subsequent increases in rates of attempting to stop smoking and reducing smoking, but not with smoking cessation. Non‐daily use of e‐cigarettes while smoking does not appear to be associated with cessation attempts, cessation or reduced smoking.
Highlights
In electronic cigarettes, a battery-powered heating element heats a solution, usually containing nicotine, to produce a aerosol
More than 90% of current smokers and recent ex-smokers were aware of e-cigarettes, approximately a third had ever used e-cigarettes and a fifth was currently using them
Use of e-cigarette use while smoking at one time-point is associated with subsequent increases in rates of attempting to quit smoking and reducing smoking, but not with increased smoking cessation
Summary
A battery-powered heating element heats a solution, usually containing nicotine, to produce a aerosol. The vast majority of e-cigarette users report using them to stop smoking tobacco [6,9] and in England, for example, smokers attempting to stop smoking use e-cigarettes more often than any other aid, including nicotine replacement therapy (NRT) [10]. Smoking prevalence in England has been declining from 20% in 2012 to 18.4% in 2014 (up to October), and in 2014 smoking cessation rates were the highest since at least 2008 [10,11] This simultaneous increase in e-cigarette use and cessation may be coincidental, and it is vitally important for longitudinal studies to be conducted to assess the impact of e-cigarette usage on quitting behaviour.
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