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, 358, j3262

E-cigarette Use and Associated Changes in Population Smoking Cessation: Evidence From US Current Population Surveys


E-cigarette Use and Associated Changes in Population Smoking Cessation: Evidence From US Current Population Surveys

Shu-Hong Zhu et al. BMJ.


Objective To examine whether the increase in use of electronic cigarettes in the USA, which became noticeable around 2010 and increased dramatically by 2014, was associated with a change in overall smoking cessation rate at the population level.Design Population surveys with nationally representative samples.Setting Five of the US Current Population Survey-Tobacco Use Supplement (CPS-TUS) in 2001-02, 2003, 2006-07, 2010-11, and 2014-15.Participants Data on e-cigarette use were obtained from the total sample of the 2014-15 CPS-TUS (n=161 054). Smoking cessation rates were obtained from those who reported smoking cigarettes 12 months before the survey (n=23 270). Rates from 2014-15 CPS-TUS were then compared with those from 2010-11 CPS-TUS (n=27 280) and those from three other previous surveys.Main outcome measures Rate of attempt to quit cigarette smoking and the rate of successfully quitting smoking, defined as having quit smoking for at least three months.Results Of 161 054 respondents to the 2014-15 survey, 22 548 were current smokers and 2136 recent quitters. Among them, 38.2% of current smokers and 49.3% of recent quitters had tried e-cigarettes, and 11.5% and 19.0% used them currently (every day or some days). E-cigarette users were more likely than non-users to attempt to quit smoking, 65.1% v 40.1% (change=25.0%, 95% confidence interval 23.2% to 26.9%), and more likely to succeed in quitting, 8.2% v 4.8% (3.5%, 2.5% to 4.5%). The overall population cessation rate for 2014-15 was significantly higher than that for 2010-11, 5.6% v 4.5% (1.1%, 0.6% to 1.5%), and higher than those for all other survey years (range 4.3-4.5%).Conclusion The substantial increase in e-cigarette use among US adult smokers was associated with a statistically significant increase in the smoking cessation rate at the population level. These findings need to be weighed carefully in regulatory policy making regarding e-cigarettes and in planning tobacco control interventions.

Conflict of interest statement

Competing interests: All authors have completed the ICMJE uniform disclosure form at and declare: S-HZ has received a grant from the National Institutes of Health for this work. All authors declare no financial relationships with any organizations that might have an interest in the submitted work in the previous three years; and no other relationships or activities exist that could appear to have influenced the submitted work.


Fig 1 Quit attempt rate and annual cessation rate by e-cigarette use status, 2014-15, USA. CPS-TUS=Current Population Survey-Tobacco Use Supplement
Fig 2 Quit attempt rate and annual cessation rate from 2001-02 to 2014-15, USA. CPS-TUS=Current Population Survey-Tobacco Use Supplement

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