Article Text

Download PDFPDF

Changes in smoking cessation assistance in the European Union between 2012 and 2017: pharmacotherapy versus counselling versus e-cigarettes
  1. Filippos T Filippidis1,2,
  2. Anthony A Laverty1,
  3. Ute Mons3,
  4. Carlos Jimenez-Ruiz4,
  5. Constantine I Vardavas2,5,6
  1. 1 Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, UK
  2. 2 Center for Health Services Research, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
  3. 3 Cancer Prevention Unit and WHO Collaborating Centre for Tobacco Control, German Cancer Research Center, Heidelberg, Germany
  4. 4 Smoking Cessation Service, Community of Madrid, Madrid, Spain
  5. 5 Institute of Public Health, American College of Greece, Athens, Greece
  6. 6 Nicotine Dependence Center, Mayo Clinic, Rochester, Minnesota, USA
  1. Correspondence to Dr Filippos T Filippidis, Department of Primary Care and Public Health, School of Public Health, Imperial College London, London W6 8RP, UK; f.filippidis{at}


Background The landscape of smoking cessation may have changed in Europe recently.

Objectives To identify changes in use of smoking cessation assistance in the European Union (EU) and factors associated with use of cessation assistance.

Methods Data from the 2012 (n=9921) and 2017 (n=9489) waves of the Eurobarometer survey were used. Self-reported use of smoking cessation assistance was assessed among smokers who had ever tried to quit and former smokers. Changes in use of each type of assistance were assessed using logistic regression.

Results Among current and former smokers, those who had ever attempted to quit without assistance increased from 70.3% (2012) to 74.8% (2017). Current smokers were more likely to have used any assistance compared with former smokers (P<0.001). Use of e-cigarettes for smoking cessation assistance increased (3.7% to 9.7%)%), while use of pharmacotherapy (14.6% to 11.1%)%) and smoking cessation services (7.5% to 5.0%)%) declined. Younger people were more likely to have reported e-cigarette use for smoking cessation but less likely to have used a cessation service. Individuals living in countries with comprehensive smoking cessation policies were more likely to have used any cessation assistance (adjusted OR (aOR)=1.78; 95% CI 1.15 to 2.76), pharmacotherapy (aOR=3.44; 95% CI 1.78 to 6.66) and smoking cessation services (aOR=2.27; 95% CI 1.27 to 4.06) compared with those living in countries with weak smoking cessation policies.

Conclusions These findings highlight the need for approaches that ensure that smokers get support to quit smoking across the EU. The question of whether the availability of e-cigarettes will displace other methods, and the impact of such a displacement, should be closely evaluated.

  • cessation
  • electronic nicotine delivery devices
  • non-cigarette tobacco products

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:

View Full Text

Statistics from


  • Contributors FTF had the main role in study conception and data analysis. All authors contributed to manuscript preparation and data interpretation. All authors have read and approved the final version of the manuscript.

  • Funding This work was supported by a grant from the European Commission (Horizon2020 HCO-6- 2015; EUREST-PLUS: 681109; Vardavas). AAL receives funding from the NIHR (RP 2014- 04-032).

  • Competing interests None declared.

  • Patient consent Detail has been removed from this case description/these case descriptions to ensure anonymity. The editors and reviewers have seen the detailed information available and are satisfied that the information backs up the case the authors are making.

  • Ethics approval Data were freely available and deidentified, thus no ethical approval was required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement The datasets supporting the conclusions of this article are freely available online, doi:10.4232/1.12265 in

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.