Daily vaping linked to more recently quitting cigarettes

Author: Louise Prime

People in Europe who use electronic cigarettes daily are more likely than people who don’t vape to have recently quit smoking conventional cigarettes, research has shown. The authors of the study*, published in Tobacco Control, said they found that vaping was rare among people who had quit smoking at least a decade ago, suggesting that people trying to quit smoking might switch from conventional to e-cigarettes, and later also quit vaping.

The researchers noted that there has been conflicting evidence over whether or not e-cigarettes are helpful in quitting smoking, although they have been marketed in recent years as alternatives to smoking – some studies have found that e-cigarettes (particularly frequent use, use of new- generation products and use as part of a quit attempt), are effective in smoking cessation but other cohort studies have shown that e-cigarette users are less likely to quit compared with non- users. Meta-analyses of studies evaluating the effects of e-cigarettes on smoking cessation have also reported conflicting findings; and until recently, randomised controlled trials (RCTs) showed modest results, mainly because of the use of outdated products.

For their own study, they analysed data from a cross-sectional survey of EU citizens, representative of the population (Special Eurobarometer 458); this was performed in March 2017 in 28 EU member states with the main aim of examining the prevalence of use and attitudes of Europeans towards tobacco and e-cigarettes. As well as demographic information, participants recorded their past and present use of different tobacco products and e-cigarettes, including frequency of use.

Their analysis of these data showed that 97.7% of former smokers who had quit more than 10 years previously said they had never used e-cigarettes; in contrast, current daily e-cigarette use was more prevalent in former smokers who had quit ≤2 and 3–5 years previously, compared with all other groups. The prevalence of current occasional use was low and was more prevalent in former smokers of ≤2 years, as was former daily use. Former occasional use was equally prevalent among former smokers of ≤2, 3–5 and 6–10 years. The highest prevalence of former e-cigarette use was observed among former smokers of ≤2 years,  and was more than 10-fold lower in former smokers of >10 years.

The study authors said: “Former daily e-cigarette use was positively associated with smoking cessation of ≤2 years indicating that some smokers may have quit with e-cigarettes and then quit e-cigarette use too.” They commented that their findings suggest that today’s smokers who want to quit are using e-cigarettes as an aid to do so, whereas in the past quitters had to rely on other smoking cessation aids – so few long-standing quitters have tried e-cigarettes.

They concluded: “Current daily e-cigarette use was strongly associated with recent (≤5 years) smoking cessation in EU in 2017. Former daily e-cigarette use was also association with recent (≤2 years) smoking cessation. Duration of smoking cessation was a major determinant in understanding the complex interaction between smoking and e-cigarette use in the EU population, and this parameter may be important in examining the impact of e-cigarettes in future population studies.”

*Farsalinos KE, Barbouni A. Association between electronic cigarette use and smoking cessation in the European Union in 2017: analysis of a representative sample of 13,057 Europeans from 28 countries. Tob Control; Epub ahead of print: 3 February 2020 doi:10.1136/tobaccocontrol-2019-055190