Association Between Electronic Cigarette Use and Smoking Reduction in France

Summary of Study

Bottom Line: This study found that electronic cigarette (EC) use and decreased smoking were directly correlated both in terms of cigarettes smoked per day and smoking cessation. This result suggests that EC use is an effective aid in quitting or reducing smoking.

Cigarette smoking remains a major public health problem. Traditional stop smoking aids have low appeal. Yet studies show that smokers who use smoking cessation aids are more likely to remain abstinent. Studies indicate that, in France, 82% of smokers and 89% of former smokers who use ECs consider them an aid to quit smoking or prevent a relapse.

Randomized clinical trials have shown that ECs are as effective as or more effective than nicotine replacement therapy when it comes to smoking reduction or cessation. However, prior studies have been based on relatively small samples or were conducted for short follow-up periods and have limited external validity.

This study investigates whether EC use is associated with changes in the number of cigarettes smoked, with smoking cessation rates among smokers, and with smoking relapse among former smokers.

The results demonstrate that after controlling for demographic, socioeconomic, substance use–related characteristics, and health characteristics, the estimated number of cigarettes smoked per day was significantly lower among EC users than among nonusers. EC users decreased the number of cigarettes smoked significantly more during the course of follow-up than did nonusers (-4.4 cigarettes vs. -2.7 cigarettes per day).

Additionally, EC users were more likely to quit smoking during follow-up compared with non-users (univariate relative risk). In additional analyses, this association was stronger among participants who used ECs for more than 1 year than among those who used ECs for less than 1 year. These findings suggest that EC use can help people reduce their smoking levels.

While this study found that regular EC use is associated with a significantly higher decrease in the number of cigarettes smoked per day as well as an increase in smoking cessation, among former smokers, EC use is associated with an increase in the rate of smoking relapse. In the general population, EC efficacy with regard to smoking abstinence in the long term is uncertain.

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Feature Charticle

JAMAChanges in Cigarette Smoking as a Function of E-Cigarette Use

 

Findings:

  • Among daily smokers in France, electronic cigarette (EC) use is associated with a significantly higher decrease in the number of cigarettes smoked per day as well as an increase in smoking cessation. 
  • After controlling for other variables, EC users smoked 4.4 fewer cigarettes per day between baseline and follow-up, and had a significantly higher rate of smoking cessation. 
  • These results suggest that ECs are an effective stop-smoking aid, yet in the general population EC efficacy in smoking abstinence in the long term is uncertain.