Electronic Cigarettes Efficacy and Safety at 12 Months: Cohort Study

PLoS One. 2015 Jun 10;10(6):e0129443. doi: 10.1371/journal.pone.0129443. eCollection 2015.

Abstract

Objective: To evaluate the safety and efficacy as a tool of smoking cessation of electronic cigarettes (e-cigarettes), directly comparing users of e-cigarettes only, smokers of tobacco cigarettes only, and smokers of both.

Design: Prospective cohort study. Final results are expected in 2019, but given the urgency of data to support policies on electronic smoking, we report the results of the 12-month follow-up.

Data sources: Direct contact and structured questionnaires by phone or via internet.

Methods: Adults (30-75 years) were included if they were smokers of ≥1 tobacco cigarette/day (tobacco smokers), users of any type of e-cigarettes, inhaling ≥50 puffs weekly (e-smokers), or smokers of both tobacco and e-cigarettes (dual smokers). Carbon monoxide levels were tested in a sample of those declaring tobacco smoking abstinence.

Main outcome measures: Sustained smoking abstinence from tobacco smoking at 12 months, reduction in the number of tobacco cigarettes smoked daily.

Data synthesis: We used linear and logistic regression, with region as cluster unit.

Results: Follow-up data were available for 236 e-smokers, 491 tobacco smokers, and 232 dual smokers (overall response rate 70.8%). All e-smokers were tobacco ex-smokers. At 12 months, 61.9% of the e-smokers were still abstinent from tobacco smoking; 20.6% of the tobacco smokers and 22.0% of the dual smokers achieved tobacco abstinence. Adjusting for potential confounders, tobacco smoking abstinence or cessation remained significantly more likely among e-smokers (adjusted OR 5.19; 95% CI: 3.35-8.02), whereas adding e-cigarettes to tobacco smoking did not enhance the likelihood of quitting tobacco and did not reduce tobacco cigarette consumption. E-smokers showed a minimal but significantly higher increase in self-rated health than other smokers. Non significant differences were found in self-reported serious adverse events (eleven overall).

Conclusions: Adding e-cigarettes to tobacco smoking did not facilitate smoking cessation or reduction. If e-cigarette safety will be confirmed, however, the use of e-cigarettes alone may facilitate quitters remaining so.

Registration number: NCT01785537.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Carbon Monoxide / analysis*
  • Electronic Nicotine Delivery Systems / instrumentation
  • Electronic Nicotine Delivery Systems / methods*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Smoking / epidemiology
  • Smoking Cessation / methods*
  • Smoking Prevention*
  • Surveys and Questionnaires

Substances

  • Carbon Monoxide

Associated data

  • ClinicalTrials.gov/NCT01785537

Grant support

The authors have no support or funding to report.