According to a new study, e-cigarette use did not help smokers quit and may make smokers more prone to relapse. The Centers for Disease Control and Prevention in the United States have advised that smokers who are unable to quit may benefit from transitioning from smoking cigarettes to vaping e-cigarettes if they switch completely and avoid relapsing to cigarette smoking.
However, few studies have been conducted to determine whether smokers can successfully transition to e-cigarettes (battery-powered devices that heat a liquid made of nicotine, flavorings, and other chemicals to produce an aerosol that users inhale into their lungs) without resuming cigarette smoking.
An analysis published in the online issue of JAMA Network Open by the Herbert Wertheim School of Public Health and Human Longevity Science at the University of California San Diego and the UC San Diego Moores Cancer Center found that using e-cigarettes on a daily basis did not help smokers successfully quit smoking.
E-cigarette use did not help smokers quit and may make smokers more prone to relapse. Our findings suggest that individuals who quit smoking and switched to e-cigarettes or other tobacco products increased their risk of relapse back to smoking by 8.5 percentage points over the next year compared to those who quit using all tobacco products
Professor John P. Pierce
“Our findings suggest that individuals who quit smoking and switched to e-cigarettes or other tobacco products increased their risk of relapse back to smoking by 8.5 percentage points over the next year compared to those who quit using all tobacco products,” said first author John P. Pierce, Ph.D., Distinguished Professor at the Herbert Wertheim School of Public Health and the UC San Diego Moores Cancer Center.
“While quitting is the most critical thing a smoker can do to improve their health, data suggests that switching to e-cigarettes made quitting cigarettes less likely, not more likely.”
Researchers analyzed data from the nationally representative Population Assessment of Tobacco and Health (PATH) longitudinal research, which was conducted under contract with Westat by the National Institute on Drug Abuse (NIDA) and the FDA Center for Tobacco Products. Between 2013 and 2015, the researchers identified 13,604 smokers who were followed up on via two annual surveys to investigate changes in the usage of 12 tobacco products.
At the first annual check-up, 9.4 percent of these long-term smokers had quit. 62.9 percent of these “former smokers” remained tobacco-free, while 37.1 percent had moved to another form of tobacco usage. 22.8 percent of recent smokers who switched to another product used e-cigarettes, with 17.6 percent using e-cigarettes daily.
Recent ex-smokers who transitioned to e-cigarettes were more likely to be non-Hispanic white, had higher incomes, higher levels of tobacco dependence, and believe e-cigarettes are less dangerous than traditional cigarettes.
“Our goal in this study was to see if recent former smokers who switched to e-cigarettes or another tobacco product were less likely to relapse to cigarette smoking than those who remained tobacco free,” said senior author Karen Messer, Ph.D., professor and division chief of biostatistics at the Herbert Wertheim School of Public Health.
The authors compared former smokers who had quit smoking to those who had transitioned to e-cigarettes or other tobacco products in the second annual follow-up. Individuals who transitioned to any other kind of tobacco use, including e-cigarettes, were 8.5 percentage points more likely to relapse than former smokers who had stopped using all tobacco.
At the second follow-up, 50 percent of recent former smokers who abstained from all tobacco products had been off cigarettes for 12 months or more and were considered to have successfully quit smoking, compared to 41.5 percent of recent former smokers who switched to any other form of tobacco use, including e-cigarettes.
While those who switched were more likely to relapse, they were also more likely to try to stop again and stay smoke-free for at least three months at the second follow-up. According to the researchers, a follow-up study is needed to determine whether this is indicative of a pattern of chronic stopping and relapse to cigarette smoking, or whether it is part of the path toward successful quitting.
“This is the first study to look closely at whether switching to a less dangerous nicotine source can be sustained over time without relapsing into cigarette smoking,” Pierce added. “If switching to e-cigarettes was a feasible means to quit smoking, then individuals who switched to e-cigarettes should have substantially lower relapse rates. We discovered no evidence of this.”
