E-cigarette use and associated changes in population smoking cessation: evidence from US current population surveys

Abstract

Objective To examine whether the increase in use of electronic cigarettes in the USA, which became noticeable around 2010 and increased dramatically by 2014, was associated with a change in overall smoking cessation rate at the population level. Design Population surveys with nationally representative samples. Setting Five of the US Current Population Survey-Tobacco Use Supplement (CPS-TUS) in 2001-02, 2003, 2006-07, 2010-11, and 2014-15. Participants Data on e-cigarette use were obtained from the total sample of the 2014-15 CPS-TUS (n=161 054). Smoking cessation rates were obtained from those who reported smoking cigarettes 12 months before the survey (n=23 270). Rates from 2014-15 CPS-TUS were then compared with those from 2010-11 CPS-TUS (n=27 280) and those from three other previous surveys. Main outcome measures Rate of attempt to quit cigarette smoking and the rate of successfully quitting smoking, defined as having quit smoking for at least three months. Results Of 161 054 respondents to the 2014-15 survey, 22 548 were current smokers and 2136 recent quitters. Among them, 38.2% of current smokers and 49.3% of recent quitters had tried e-cigarettes, and 11.5% and 19.0% used them currently (every day or some days). E-cigarette users were more likely than non-users to attempt to quit smoking, 65.1% v 40.1% (change=25.0%, 95% confidence interval 23.2% to 26.9%), and more likely to succeed in quitting, 8.2% v 4.8% (3.5%, 2.5% to 4.5%). The overall population cessation rate for 2014-15 was significantly higher than that for 2010-11, 5.6% v 4.5% (1.1%, 0.6% to 1.5%), and higher than those for all other survey years (range 4.3-4.5%). Conclusion The substantial increase in e-cigarette use among US adult smokers was associated with a statistically significant increase in the smoking cessation rate at the population level. These findings need to be weighed carefully in regulatory policy making regarding e-cigarettes and in planning tobacco control interventions.

E-cigarettes and Adult Smoking

“…The purpose of this table is to examine the descriptive data on differences between e-cig users and non-users in quit attempts, failures, number of failures, successes and demographics. The data in Table 1 are very similar to the data presented by Zhu et al (2017) who also used the TUS. Data are presented first for those who report using e-cigs and second for those who report not using ecigs.…”

“…Zhu et al (2017) finds that those who report use of e-cigs had a higher smoking cessation rate than those who report no use of e-cigs. They relied on data from the Tobacco Use Supplements.…”

Does E-Cigarette Advertising Encourage Adult Smokers to Quit?

“…The almost two percentage point decline in smoking between 2014 and 2015 was the largest in more than twenty years (Jamal et al 2016). In other national data, Zhu et al (2017) find that the quit attempt rate and annual cessation rate were higher in 2014-15 compared to surveys earlier in the 2000s prior to the surge in e-cigarettes use. Figure 2 shows that the growth in e-cigarette use among youth was also accompanied by a downward trend in youth smoking.…”

Electronic Cigarette Use Prevalence, Associated Factors, and Pattern by Cigarette Smoking Status in the United States From NHANES (National Health and Nutrition Examination Survey) 2013–2014

“…The high prevalence of e‐cigarette use among current smokers should be interpreted carefully. Some studies have implied that this result means that e‐cigarettes are being used as smoking‐cessation devices,21 whereas others stated that dual use increases exposure to nicotine and may perpetuate abuse liability instead of encouraging smoking cessation 22. Indeed, newer devices, even with low concentrations of nicotine, can deliver similar or higher levels of nicotine than cigarettes 23, 24…”