E-Cigarettes and Smoking Cessation in the U.S. According to Frequency of E-Cig Use and Quitting Duration: Analysis of the 2016 and 2017 National Health Interview Surveys

Bottom Line: This analysis of the two most recent years of publicly-available, population-representative surveys of U.S. adults concludes that daily e-cigarette use was strongly associated with recent smoking cessation.

There is controversy about whether e-cigarettes promote or prevent smoking cessation. This study presents a detailed analysis of the association between e-cigarette use and smoking cessation in the United States considering the frequency of electronic cigarette use and duration of smoking cessation. 

Current e-cigarette use was reported by 10.5% of current smokers and 4.5% of former smokers. Prevalence was high in former smokers of <1 year, 1-3 years, and 4-6 years, and very low in former smokers of >6 years. Similar patterns were observed for daily e-cigarette use. 

Current e-cigarette use was negatively associated with being a former smoker when quit duration was ignored but was positively associated with being a former smoker of <1 year, 1-3 years, and 4-6 years.

These findings can be explained by two observations: (1) that the vast majority of former smokers in this study had quit for > 6 years, and (2) that e-cigarette use was minimal in this sub-population. The latter is explained by the limited availability and popularity of e-cigarettes before 2010 in the U.S. Former smokers who have quit within the past 6 years from the surveys date had a higher prevalence of daily e-cigarette use, with more than 4-fold higher use in former smokers of < 1 year and 1-3 years compared to current smokers. 

Daily e-cigarette use was strongly associated with being a recent former smoker. It is reasonable to expect that frequent use is needed for any smoking cessation aid (including pharmaceuticals) in order to successfully combat cigarette smoking withdrawal symptoms to improve the chances of quitting. 

Daily e-cigarette use could also indicate more motivation to use them as smoking cessation aids compared to other reasons for occasional use such as avoidance of public place smoking bans or simply sensation seeking. These findings are in agreement with other studies showing that frequent e-cigarette use is positively associated with smoking cessation attempts and success. 

Read the full report here.