Changes in E-Cigarette Use Behaviors and Dependence in Long-term E-Cigarette Users

Summary of Study

Bottom Line: The vast majority of exclusive e-cigarette users remain exclusive e-cigarette users over a period of years. The majority of poly users (e-cigarette and traditional cigarette users) became exclusive e-cigarette users over the same period. These findings suggest the risk of relapse to cigarette smoking is low and e-cigarettes are a useful tool in helping people quit traditional cigarettes. 

In previous research, current exclusive e-cigarette users who were former smokers were found to be less dependent on e-cigarettes than they were when they used cigarettes, implying a reduced dependence from e-cigarette use rather than cigarette smoking. Based on available evidence, the National Academies of Science, Engineering, and Medicine concluded that, “there is moderate evidence that risk and severity of dependence are lower for e-cigarettes than combustible tobacco cigarettes.” Therefore, e-cigarettes may be a potential tool to help adult smokers reduce or quit smoking.

Because most adult e-cigarette users are either current or former smokers, the concurrent use of e-cigarettes with other tobacco products—primarily cigarettes—raises concerns of possible relapse to cigarette smoking. The goals of this longitudinal study were to examine if e-cigarette users would maintain exclusive e-cigarette use or relapse to cigarette smoking and if e-cigarette–related dependence would increase over time.

Among 402 baseline exclusive e-cigarette users, 88.3% maintained exclusive e-cigarette use at follow-up, 1.2% switched to being a poly user with other nicotine products, and 9.2% became poly users with other tobacco products, primarily involving cigarettes. 

Most baseline poly users with other nicotine products switched to exclusive e-cigarette use at follow-up. Among 71 baseline poly users with other tobacco products, 60.6% switched to using e-cigarettes exclusively at follow-up, and 28.2% remained poly users; however, 2.8% returned to exclusive cigarette smoking. 

This study demonstrates that most exclusive e-cigarette users at baseline continued using e-cigarettes exclusively on a daily basis, and the risk of relapse to cigarette smoking was low. Consistent with previous findings that frequent e-cigarette use is associated with quitting smoking, this study also provides new evidence that once users have switched to e-cigarettes, many are able to maintain exclusive e-cigarette use over a long period (up to 6 years in this study). 

Because virtually all of the study subjects were ever smokers, and approximately 30% reported that they used e-cigarettes to support smoking abstinence, the findings suggest that e-cigarette use could facilitate smoking cessation in adult smokers.

Read the full study HERE

Feature Charticle

Patterns of Exclusive E-Cigarette & Poly Use Over Time

AJPM

 

Findings:

  • Among 402 baseline exclusive e-cigarette users, 88.3% maintained exclusive e-cigarette use at follow-up, and  9.2% became poly users with other tobacco products, primarily involving cigarettes
  • Among 71 baseline poly users with other tobacco products, 60.6% switched to using e-cigarettes exclusively at follow-up, and 28.2% remained poly users
  • These findings suggest the risk of relapse to cigarette smoking is low and e-cigarettes are a useful tool in helping people quit traditional cigarettes