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Effectiveness of e-cigarettes as aids for smoking cessation: evidence from the PATH Study cohort, 2017–2019
  1. Ruifeng Chen1,
  2. John P Pierce1,2,
  3. Eric C Leas1,
  4. Tarik Benmarhnia3,
  5. David R Strong1,2,
  6. Martha M White2,
  7. Matthew Stone1,
  8. Dennis R Trinidad1,
  9. Sara B McMenamin1,
  10. Karen Messer1,2
  1. 1 Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California, USA
  2. 2 Moores Cancer Center, University of California San Diego, La Jolla, California, USA
  3. 3 Scripps Institution of Oceanography, University of California San Diego, La Jolla, California, USA
  1. Correspondence to Dr John P Pierce, Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California, USA; jppierce{at}ucsd.edu

Abstract

Objective To assess the effectiveness of e-cigarettes in smoking cessation in the USA from 2017 to 2019, given the 2017 increase in high nicotine e-cigarette sales.

Methods In 2017, the PATH Cohort Study included data on 3578 previous year smokers with a recent quit attempt and 1323 recent former smokers. Respondents reported e-cigarettes or other products used to quit cigarettes and many covariates associated with e-cigarette use. Study outcomes were 12+ months of cigarette abstinence and tobacco abstinence in 2019. We report weighted unadjusted estimates and use propensity score matched analyses with 1500 bootstrap samples to estimate adjusted risk differences (aRD).

Results In 2017, 12.6% (95% CI 11.3% to 13.9%) of recent quit attempters used e-cigarettes to help with their quit attempt, a decline from previous years. Cigarette abstinence for e-cigarette users (9.9%, 95% CI 6.6% to 13.2%) was lower than for no product use (18.6%, 95% CI 16.0% to 21.2%), and the aRD for e-cigarettes versus pharmaceutical aids was −7.3% (95% CI −14.4 to –0.4) and for e-cigarettes versus any other method was −7.7% (95% CI −12.2 to –3.2). Only 2.2% (95% CI 0.0% to 4.4%) of recent former smokers switched to a high nicotine e-cigarette. Subjects who switched to e-cigarettes appeared to have a higher relapse rate than those who did not switch to e-cigarettes or other tobacco, although the difference was not statistically significant.

Conclusions Sales increases in high nicotine e-cigarettes in 2017 did not translate to more smokers using these e-cigarettes to quit smoking. On average, using e-cigarettes for cessation in 2017 did not improve successful quitting or prevent relapse.

  • cessation
  • electronic nicotine delivery devices
  • Surveillance and monitoring
  • addiction

Data availability statement

The data are in a Restricted Use File that is available to approved researchers. National Addiction and HIV Data Archive Program. Population Assessment of Tobacco and Health (PATH) Study [United States] Restricted-Use Files (ICPSR 36231). NIH; National Institute on Drug Abuse.

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, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/tobaccocontrol-2021-056901

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    Data availability statement

    The data are in a Restricted Use File that is available to approved researchers. National Addiction and HIV Data Archive Program. Population Assessment of Tobacco and Health (PATH) Study [United States] Restricted-Use Files (ICPSR 36231). NIH; National Institute on Drug Abuse.

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    • Twitter @MatthewDavStone

    • Contributors JPP is responsible for the overall content and is the guarantor of this paper. JPP and RC conceptualised and designed the study, drafted the initial manuscript and reviewed and revised the manuscript. JPP and TB acquired funding for the study. TB and KM had input into conceptualisation and supervised the methodology and all analyses undertaken. They also reviewed and revised the manuscript for important intellectual content. ECL, SBM, DRS, MDS, DT and MMW had input into the study conceptualisation and critically reviewed the manuscript for important intellectual content. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

    • Funding Supported by the National Institutes of Health (grant R01CA234539) and by the Tobacco-Related Disease Research ProgramProgramme of the University of California, Office of the President (grants 28IR-0066 and T31IR-1584).

    • Disclaimer Neither funding source had any role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. Further, the funders of the PATH Study had no role in the analysis or interpretation of the data, its preparation, review or approval of this manuscript or decision to submit it for publication. All data used are available in a restricted public use file.

    • Competing interests None declared.

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

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.