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

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 between 2013 and 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 2014-15. More quit attempters were persistently cigarette abstinent than persistently tobacco abstinent (15.5±0.8% vs 9.6±0.6%). Using ENDS to quit cigarettes increased the probability of persistent cigarette abstinence at Wave 2 (Risk Difference (RD)=6%; 95% CI: 2%;10%), but using approved pharmaceutical aids did not (varenicline RD=2%; 95% CI: -6%,13%; buproprion RD=4%, 95% CI: -6%, 17%; NRT RD=-3%, 95% CI -8%, 2%). Among quit attempters who relapsed, ENDS did not reduce the average daily cigarette consumption (-0.18 cigarettes per day; 95% CI: -1.87;1.51).