US e-cigarette users are now more likely to quit smoking than non-vapers

The findings of a new observational study suggests that times are changing for cigarette smokers in the US, with people who use e-cigarettes now more likely to quit smoking combustible cigarettes than non-vapers.

Vaping is controversial, with opponents saying use should not be promoted as a quit smoking technique, while others say e-cigarettes can help some people quit.

“Past population-level research has reported conflicting findings on whether [Electronic Nicotine Delivery Systems] use helps people who smoke combustible cigarettes to quit smoking,” the authors write in the paper, which has been published in the journal Nicotine & Tobacco Research.

“Some research suggests improved cigarette quitting-related outcomes with ENDS use, while other research suggests ENDS use is associated with lower rates of cigarette quitting.”

To address these inconsistent findings, the new study analysed population-level data from more than 13,600 adults aged 21 and over in the Population Assessment of Tobacco and Health Study, which tracks tobacco use in people in the US. Researchers looked at trends in cigarette discontinuation rates from 2013 to 2021 by comparing US adults who smoked cigarettes and used e-cigarettes with those who smoked but did not vape.

The data indicates that between 2013 and 2016 rates of quitting smoking were indistinguishable between those who used cigarettes (15.5%) and those who did not (15.6%). But subsequent years revealed an interesting change in trends – between 2018-2021 30.9% of smokers who used e-cigarettes stopped smoking, compared to only 20% of smokers who did not vape.

First author Karin Kasza, an assistant professor of oncology in the Department of Health Behaviour at Roswell Park Comprehensive Cancer Center in the US, says that the findings “suggest that the times have changed when it comes to vaping and smoking cessation for adults in the US.”

The full study period spanned a time in the US when the e-cigarette marketplace was expanding. Beginning in 2016, manufacturers introduced e-liquids containing nicotine salt formulations that allowed increased nicotine concentrations. This was also a period in which state and federal governments restricted tobacco in various ways, including increasing the tobacco-purchase age to 21 and restricting flavoured e-cigarettes.

“While our study doesn’t give the answers as to why vaping is associated with cigarette quitting in the population today when it wasn’t associated with quitting years ago, design changes leading to e-cigarettes that deliver nicotine more effectively should be investigated,” says Kasza.

“This work underscores the importance of using the most recent data to inform public health decisions.”

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