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Tob Control. 2019 Jan;28(1):42-49. doi: 10.1136/tobaccocontrol-2017-054108. Epub 2018 Mar 24.

E-cigarette initiation and associated changes in smoking cessation and reduction: the Population Assessment of Tobacco and Health Study, 2013-2015.

Author information

1
Department of Global Health and Center for Global Health and Development, Boston University School of Public Health, Boston, Massachusetts, USA.
2
Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.
3
Department of Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts, USA.
4
Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA.
5
Department of Medicine, University of Louisville, Louisville, Kentucky, USA.
6
Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA.

Abstract

BACKGROUND:

The role of electronic cigarettes (e-cigarettes) in product transitions has been debated.

METHODS:

We used nationally representative data from the Population Assessment of Tobacco and Health Study waves 1 (2013-2014) and 2 (2014-2015) to investigate the associations between e-cigarette initiation and cigarette cessation/reduction in the USA. We limited the sample to current cigarette smokers aged 25+ years who were not current e-cigarette users at wave 1. We modelled 30-day cigarette cessation and substantial reduction in cigarette consumption as a function of e-cigarette initiation between surveys using multivariable logistic regression.

RESULTS:

Between waves 1 and 2, 6.9% of cigarette smokers who were not current e-cigarette users transitioned to former smokers. After adjusting for covariates, cigarette smokers who initiated e-cigarette use between waves and reported they used e-cigarettes daily at wave 2 had 7.88 (95% CI 4.45 to 13.95) times the odds of 30-day cigarette cessation compared with non-users of e-cigarettes at wave 2. Cigarette smokers who began using e-cigarettes every day and did not achieve cessation had 5.70 (95% CI 3.47 to 9.35) times the odds of reducing their average daily cigarette use by at least 50% between waves 1 and 2 compared with e-cigarette non-users.

CONCLUSIONS:

Daily e-cigarette initiators were more likely to have quit smoking cigarettes or reduced use compared with non-users. However, less frequent e-cigarette use was not associated with cigarette cessation/reduction. These results suggest incorporating frequency of e-cigarette use is important for developing a more thorough understanding of the association between e-cigarette use and cigarette cessation.

KEYWORDS:

ENDS; PATH; cigarette reduction; e-cigarette; e-cigarette initiation; electronic cigarette; population assessment of tobacco and health; product transitions; smoking cessation; vape; vaping

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