E-cigarette use was associated with lower long-term smoking cessation rates compared to nicotine replacement therapy or no cessation aids at all, according to a recent study.

Researchers evaluated the effectiveness of e-cigarettes as smoking cessation aids using data from the Population Assessment of Tobacco and Health (PATH) Study cohort from 2017 to 2019. The study, published in Tobacco Control, included 3,578 recent quit attempters and 1,323 recent former smokers who reported on e-cigarette use and other cessation products during their quit attempts. The primary outcomes measured were cigarette and tobacco abstinence for 12 months or more by 2019.

In 2017, 12.6% of quit attempters used e-cigarettes to aid their cessation efforts, a decrease from previous years. The study revealed that cigarette abstinence among e-cigarette users was 9.9% (95% confidence interval [CI], 6.6% to 13.2%), significantly lower than the 18.6% (95% CI, 16.0% to 21.2%) observed in those who did not use any cessation products. The adjusted risk difference for e-cigarette use compared to nicotine replacement therapy (NRT) was −7.3% (95% CI, −14.4% to −0.4%), and compared to any other cessation method, it was −7.7% (95% CI, −12.2% to −3.2%). Additionally, only 2.2% (95% CI, 0.0% to 4.4%) of recent former smokers transitioned to high-nicotine e-cigarettes, with no significant reduction in relapse rates compared to those who did not switch to e-cigarettes or other tobacco products.

The study utilized weighted unadjusted estimates and propensity score matching with 1,500 bootstrap samples to adjust for confounders such as sociodemographic factors and smoking history. The results indicated that using e-cigarettes did not increase long-term cigarette abstinence compared to traditional methods like NRT. In fact, e-cigarette users had similar relapse rates to those using other tobacco products, and e-cigarettes did not significantly reduce relapse compared to non-users.

These findings suggest that, despite the growth of the e-cigarette market and the introduction of high-nicotine products, e-cigarettes were not more effective than other methods in aiding smoking cessation. Further follow-up in future PATH surveys is needed to assess the long-term impact of high-nicotine e-cigarettes on smoking cessation.

Full disclosures can be found in the published study.