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E-cigarettes linked with higher quitting success rate, provide no change in total quit attempts

Although e-cigarettes’ increased popularity in England has not coincided with a significant change in overall attempts to quit smoking, their prevalence appears positively associated with the success rate of individual quit attempts, according to data published in BMJ.

“There has been concern that the increase in population use of electronic cigarettes (e-cigarettes) could be undermining quitting activities,” Emma Beard, PhD, MSc, of the research department of clinical, educational and health psychology at University College London, and colleagues wrote. “If this is true, then e-cigarettes could have a negative effect on public health, even if they might increase the chances of success for an individual smoker using them in a given quit attempt.”

To determine the degree to which the use of e-cigarettes has affected the success rates of those attempting to quit smoking, as well as overall quite attempts and the use of nicotine replacement therapy and other treatments, the researchers conducted a time series analysis of population trends. They collected data on 170,490 people aged 16 years and older who reported their smoking status in the Smoking Toolkit Study. The researchers aggregated data on 1,200 smokers quarterly between 2006 and 2015. In addition, they used monitoring data from the national behavioral support program.

In their analysis, the researchers used the prevalence of e-cigarette use in current smokers and during an attempt to quit to predict a successful attempt. E-cigarette use among current smokers was used to predict the rate of attempts at quitting. The rate of quit attempts that involve e-cigarettes was used to predict quit attempts using nicotine replacement therapy and other treatments.

According to the researchers, the success rate of attempts to quit smoking increased by 0.098% (95% CI, 0.064-0.132; P < .001) for every 1% increase in the prevalence of e-cigarettes use by smokers. In addition, the success rate increased 0.058% (95% CI, 0.038-0.078; P < .001) for every 1% increase in the prevalence of e-cigarettes use among those who recently attempted to quit. The researchers also reported a negative association between e-cigarette use during a recent quit attempt and the use of prescription nicotine replacement therapy (β –0.089; 95% CI, –0.189 to –0.007; P = .04). They found no clear association between e-cigarette use and the rate of quit attempts, the use OTC nicotine replacement therapy, the use of other prescription treatment, or the use of behavioral support.

“The increased prevalence of e-cigarettes in England does not appear to have been associated with a detectable change in attempts to stop smoking,” Beard and colleagues wrote. “However, the increase in e-cigarettes use has been associated with an increase in success of quit attempts. Growth in the use of e-cigarettes for quitting has also been associated with a decline in the use of [nicotine replacement therapy] obtained on prescription, but has not clearly been associated with the use of other quitting support.” – by Jason Laday

Disclosure: Beard reports receiving unrestricted research funding from Pfizer and is funded by CRUK and SPHR. Please see the full study for all other researchers’ relevant financial disclosures.