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

Am J Epidemiol. 2018 Nov 1;187(11):2397-2404. doi: 10.1093/aje/kwy129.


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).

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Electronic Nicotine Delivery Systems / statistics & numerical data*
  • Female
  • Humans
  • Male
  • Propensity Score
  • Racial Groups
  • Smoking Cessation / methods*
  • Smoking Cessation / statistics & numerical data*
  • Smoking Cessation Agents / administration & dosage
  • Smoking Cessation Agents / therapeutic use*
  • Socioeconomic Factors
  • Tobacco Use Cessation Devices / statistics & numerical data*
  • Treatment Outcome
  • United States
  • Young Adult


  • Smoking Cessation Agents