E-cigarettes and Smoking Cessation in Smokers With Chronic Conditions

Am J Prev Med. 2019 Dec;57(6):786-791. doi: 10.1016/j.amepre.2019.08.017.


Introduction: Many smokers with chronic medical conditions use e-cigarettes. This study assessed the association between e-cigarette use and subsequent smoking-cessation efforts in adult smokers with and without chronic medical conditions.

Methods: This was a longitudinal cohort study of adult cigarette smokers using Waves 1 and 2 of the Population Assessment of Tobacco and Health Study (2013-2015), analyzed in 2018‒2019. The exposure was the initiation of e-cigarette use by Wave 2. The outcomes at Wave 2 were: (1) past 12-month attempts to quit, (2) cigarette abstinence, (3) ≥50% reduction in cigarette use, and (4) past 12-month use of evidence-based smoking-cessation treatment.

Results: E-cigarette use initiation was associated with increased odds of attempting to quit smoking at Wave 2 among smokers with any chronic medical condition (AOR=1.92, 95% CI=1.42, 2.59) and without chronic medical conditions (AOR=1.81, 95% CI=1.50, 2.18). E-cigarette use initiation was also significantly associated with Wave 2 smoking abstinence in smokers with (AOR=1.95, 95% CI=1.11, 3.43) and without chronic medical conditions (AOR=1.63, 95% CI=1.17, 2.28).

Conclusions: At a population level, e-cigarette use by smokers with chronic medical conditions is associated with more quitting activity and smoking abstinence. Future studies are needed to assess e-cigarette safety and efficacy to determine whether they may provide an alternative smoking-cessation or harm-reduction strategy for adults with smoking-sensitive disease who cannot achieve these goals with other methods.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Chronic Disease / prevention & control*
  • Chronic Disease / rehabilitation
  • Cigarette Smoking / adverse effects
  • Cigarette Smoking / prevention & control*
  • Electronic Nicotine Delivery Systems / statistics & numerical data
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Smokers / statistics & numerical data*
  • Smoking Cessation / methods
  • Smoking Cessation / statistics & numerical data*
  • Vaping / epidemiology*
  • Young Adult