Smokers Who Vape Are Less Likely to Quit Smoking

While some recent studies have touted e-cigarettes as an effective aid to smoking cessation, a new study in the American Journal of Public Health suggests that these increasingly popular battery-operated devices may actually be a hindrance to quitting rather than a help.

Researchers found smokers who used e-cigarettes were 49% less likely to decrease cigarette use and 59% less likely to quit smoking compared to smokers who never used e-cigarettes.
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“Based on the idea that smokers use e-cigarettes to quit smoking, we hypothesized that smokers who used these products would be more successful in quitting—but the research revealed the contrary,” said study author Wael Al-Delaimy, MD, PhD, professor and chief of the Division of Global Public Health in the Department of Family Medicine and Public Health at the University of California, San Diego School of Medicine.

To determine whether smokers who used e-cigarettes were more likely to quit after 1 year than smokers who had never used them, Al-Delaimy and his colleagues conducted a telephone survey of 1,000 California smokers ages 18 to 59 at baseline and then administered the same survey to them 1 year later.

The first survey revealed that about 25% of participants had used e-cigarettes, about a third said they might use them, another third said they would never use them, and the remainder had never heard of them.

They analyzed data from smokers who reported consistent e-cigarette behavior at baseline and follow-up to determine whether a history of e-cigarette use at baseline predicted quitting behavior at follow-up.

“Compared with smokers who never used e-cigarettes, smokers who ever used e-cigarettes were significantly less likely to decrease cigarette consumption, and significantly less likely to quit for 30 days or more at follow-up,” the authors concluded.

Results showed that daily smokers and women were more likely to have tried e-cigarettes. They also found that intention to quit was associated with a significantly increased likelihood of quitting smoking, and daily smokers were considerably less likely to quit than occasional smokers.

The authors believe these findings may have important implications for policies and regulations regarding the use of e-cigarettes among smokers; however, longitudinal studies like this are not designed to establish causality.

“We need further studies to answer why they cannot quit,” Al-Delaimy said. “One hypothesis is that smokers are receiving an increase in nicotine dose by using e-cigarettes.”

A high-quality randomized controlled trial with a larger and more diverse patient population would be needed to determine the direct influence of e-cigarette use on quitting smoking and how it compares to other methods of smoking cessation.

—Colleen Mullarkey

Reference

Al-Delaimy WK, Myers MG, Leas EC, Strong DR, Hofstetter CR. E-cigarette use in the past and quitting behavior in the future: a population-based study. Am J Public Health. 16 April 2015. [Epub ahead of print].