E-cigarettes: May help cessation for current smokers, increase relapse risk among former smokers
Although regular electronic cigarette use was associated with a reduction in the number of cigarettes smoked among current smokers, it was also associated with an increase in the rate of relapse among former smokers, according to a study published in JAMA Internal Medicine.
“Electronic cigarettes are generally used by smokers who consider them to be less harmful than conventional cigarettes and try to reduce or quit their cigarette consumption,” Ramchandar Gomajee, MSc, of Sorbonne University in France, and colleagues wrote. “In some countries, such as France, electronic cigarettes have become the leading smoking cessation methods. However, the effectiveness of electronic cigarettes as a smoking reduction and cessation aid is still a subject of controversy. ... Because former smokers may relapse at different rates, some after only a few days and others after several months, it is necessary to follow the consequences of electronic cigarette use over extended periods of time.”
To examine the association between regular (ie, daily) e-cigarette use and smoking patterns, researchers conducted a cohort study of 5,400 current smokers and 2,025 former smokers who were enrolled between 2012 and 2015 (former smokers defined as those who quit smoking in 2010 or afterward). Of the current smokers, 822 used e-cigarettes. Of the former smokers, 176 used e-cigarettes.
For those who were current smokers at baseline, the primary outcomes were the association between e-cigarette use and the number of conventional cigarettes smoked during follow-up and the likelihood of smoking cessation. The primary outcome for former smokers was the association between e-cigarette use and smoking relapse.
Current smokers were followed for a mean of 23.4 months and former smokers were followed for a mean of 22.1 months.
Researchers found that found that, among current smokers, regular e-cigarette use was associated with a significantly higher decrease in the number of cigarettes smoked per day compared with current smokers who did not use e-cigarettes (–4.4 vs. –2.7).
E-cigarette use was also associated with a higher adjusted relative risk of smoking cessation among current smokers (1.67; 95% CI, 1.51-1.84).
When considering former smokers, researchers found that e-cigarette use was associated with an increase in the rate of smoking relapse (adjusted HR = 1.70; 95% CI, 1.25-2.3).
“Although electronic cigarette use may help individuals decrease smoking levels and initiate smoking cessation, it is not clear whether it leads to complete long-term cessation,” the researchers concluded. – by Melissa J. Webb
Disclosures: Gomajee reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.