Can E-Cigarettes and Pharmaceutical Aids Increase Smoking Cessation and Reduce Cigarette Consumption? Findings From a Nationally Representative Cohort of American Smokers

• Published in: American journal of epidemiology Vol. 187; no. 11; pp. 2397 - 2404
• Main Authors: Benmarhnia, Tarik, Pierce, John P, Leas, Eric, White, Martha M, Strong, David R, Noble, Madison L, Trinidad, Dennis R
• Format: Journal Article
• Language: English
• Published: United States Oxford University Press 01.11.2018; Oxford Publishing Limited (England)
• Subjects: Adolescent; Adult; Aids; Bupropion; Cigarette smoking; Cigarettes; Confidence intervals; Drug addiction; Editor's Choice; Electronic cigarettes; Electronic Nicotine Delivery Systems - statistics & numerical data; Female; Humans; Male; Missing data; Nicotine; Original Contributions; Pharmaceuticals; Propensity Score; Racial Groups; Smoking; Smoking cessation; Smoking Cessation - methods; Smoking Cessation - statistics & numerical data; Smoking Cessation Agents - administration & dosage; Smoking Cessation Agents - therapeutic use; Socioeconomic Factors; Standard error; Statistical analysis; Tobacco; Tobacco Use Cessation Devices - statistics & numerical data; Treatment Outcome; United States; Young Adult; United States; ENDS; propensity score matching; electronic nicotine delivery systems; cessation; pharmaceutical aids
• ISSN: 0002-9262; 1476-6256
• DOI: 10.1093/aje/kwy129

Abstract Many smokers believe that electronic nicotine delivery systems (ENDS) and pharmaceutical cessation aids can help them quit smoking or reduce cigarette consumption, but the evidence for e-cigarettes to aid quitting is limited. Examining 3,093 quit attempters in the nationally representative US Population Assessment of Tobacco and Health (PATH) Study, using data from 2013–2015, we evaluated the influence of ENDS and pharmaceutical cessation aids on persistent abstinence (≥30 days) from cigarettes and reduced cigarette consumption, using propensity score matching to balance comparison groups on potential confounders and multiple imputation to handle missing data. At PATH Wave 2, 25.2% of quit attempters reported using ENDS to quit during the previous year, making it the most popular cessation aid in 2014–2015. More quit attempters were persistently cigarette abstinent than were persistently tobacco abstinent (15.5% (standard error, 0.8) vs. 9.6% (standard error, 0.6)). Using ENDS to quit cigarettes increased the probability of persistent cigarette abstinence at Wave 2 (risk difference (RD) = 6%, 95% confidence interval (CI): 2, 10), but using approved pharmaceutical aids did not (for varenicline, RD = 2%, 95% CI: −6, 13; for bupropion, RD = 4%, 95% CI: −6, 17; for nicotine replacement therapy, RD = −3%, 95% CI: −8, 2). Among quit attempters who relapsed, ENDS did not reduce the average daily cigarette consumption (cigarettes per day, −0.18, 95% CI: −1.87, 1.51).