A Longitudinal Analysis of Electronic Cigarette Use and Smoking Cessation

Study Questions:

Do electronic cigarettes (e-cigarettes) improve smoking cessation rates compared to other methods or placebo?


This research letter describes data on e-cigarette use in association with quit rates. Participants from the Knowledge Networks who completed a baseline survey in November 2011 and were self-identified current smokers were included in this analysis. Follow-up was conducted through November 2012. A total of 1,549 participants completed the survey in 2011, of which 1,189 were current smokers; 81.3% completed the follow-up survey. An additional 240 provided nonsensical data and were excluded. Baseline e-cigarette (in the prior 30 days) use was measured with the yes or no question. Cigarettes used per day (continuous variable), time to first cigarette (<30 vs. ≥30 minutes), and intention to quit (never, not in next 6 months, within next 6 months, within next month) were measured at baseline and follow-up.


A total of 949 participants were included in this analysis. Women, younger adults, and individuals with less education were more likely to report using e-cigarettes. At baseline, a greater proportion of e-cigarette users reported smoking their first cigarette <30 minutes after waking compared with nonusers (p = 0.046). Baseline e-cigarette use was not significantly associated with greater intention to quit smoking (p = 0.09). E-cigarette use at baseline did not significantly predict quitting 1 year later (odds ratio [OR], 0.71; 95% confidence interval [CI], 0.35-1.46; p = 0.35). Intention to quit (OR, 5.59; 95% CI, 2.41-12.98; p < 0.001) and cigarettes smoked per day (OR, 0.97; 95% CI, 0.94-0.99; p = 0.02) significantly predicted quit status. Among participants who reported smoking at both baseline and follow-up, e-cigarette use at baseline was not associated with a change in cigarette consumption (p = 0.25), controlling for baseline cigarette consumption.


The investigators concluded that e-cigarette use by smokers was not followed by greater rates of quitting or by reduction in cigarette consumption 1 year later. Regulations should prohibit advertising claiming or suggesting that e-cigarettes are effective smoking cessation devices until claims are supported by scientific evidence.


These data suggest that e-cigarette use is not associated with higher quit rates. However, given the small number of e-cigarette users and use of self-reported data on smoking cessation, further study is warranted.

Clinical Topics: Prevention, Smoking

Keywords: Follow-Up Studies, Tobacco Use Disorder, Smoking Cessation, Smoking, Vaccines, Conjugate

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