Headlines - E-cigarettes and Attempts to Quit Smoking

Since their introduction to the market in the late 2000s, electronic cigarettes (or e-cigarettes) have become popular, with 6% of people aged 15–75 using them, half of whom were daily users [France, 2014]. Among vapers, 83% were also tobacco smokers and 15% were former smokers. In France, the High Council for Public Health published an opinion in 2016 in which it presented the e-cigarette as “a tool to aid in smoking cessation for people wishing to quit smoking” and as “a means of reducing the risks of tobacco use when used exclusively,” but highlighted the risk of renormalizing smoking. However, existing knowledge on the effect of e-cigarette use on smoking cessation is contradictory. A recent study by Santé publique France assessed whether regular use of e-cigarettes by smokers is associated with smoking cessation. Via the Internet, 2,057 residents of metropolitan France aged 15 to 85 responded to an initial survey and participated in a 6-month follow-up. At recruitment, 1,805 (88%) were exclusive tobacco smokers and 252 were vape-smokers (smokers who regularly use e-cigarettes).The three main indicators measured at 6 months were: a reduction of at least 50% in the number of cigarettes smoked per day, quit attempts lasting at least 7 days, and successful smoking cessation for at least 7 days as of the follow-up date. The statistical models used accounted for socioeconomic variables and characteristics of tobacco use: - Vape-smokers were more likely than exclusive smokers to have halved their daily cigarette consumption within 6 months (25.9% vs. 11.2%, p<0.001, ORa*=2.6, 95% CI: [1.8–3.8]).- They had also made an attempt to quit for at least 7 days more often (22.8% vs. 10.9%, p < 0.001, ORa* = 1.8 [1.2–2.6]).- No significant difference was observed in quit rates for 7 days or more at 6 months (12.5% vs. 9.5%, p=0.18, ORa*=1.2 [0.8-1.9]).Thus, among smokers, those who regularly used an e-cigarette were more likely to have attempted to quit smoking and had reduced their cigarette consumption at the 6-month follow-up. However, 6 months later, it was not demonstrated that these vapers were more likely than other smokers to have quit smoking, and the effectiveness of e-cigarettes for smoking cessation remains a subject of debate. Regular vaping among smokers may have only a short-term effect, encouraging attempts to quit but not long-term smoking cessation. This may be consistent with the fact that in France, in 2014, nearly half of vapers used e-cigarettes for a short period (less than 3 months).

* ORa = adjusted odds ratio