The association between frequency of e-cigarette use and long-term smoking cessation outcomes among treatment-seeking smokers receiving a behavioral intervention

Drug Alcohol Depend. 2021 Jan 1:218:108394. doi: 10.1016/j.drugalcdep.2020.108394. Epub 2020 Nov 1.

Abstract

Introduction: A growing body of literature suggests daily, but not non-daily, e-cigarette use is associated with greater odds of quitting combustible cigarettes in the general adult population. However, it is unknown if these findings generalize to treatment-seeking smokers who are receiving a behavioral intervention. Our primary aim was to examine whether frequency of e-cigarette use was associated with subsequent cessation among treatment-seeking smokers who are receiving a behavioral smoking cessation intervention.

Methods: Participants (N = 2637) enrolled in a RCT of web-based smoking treatments reported their use of e-cigarettes at baseline, 3-, and 6-months. Three groups were created based on e-cigarette use: (1) non-users, (2) intermittent users, and (3) daily users. The primary outcome was complete-case, self-reported 30-day point prevalence abstinence at 12 months.

Results: Compared to non-users, daily e-cigarette users were significantly less likely to be abstinent (21.39 % vs. 29.68 %; p = .006). Quit rates for intermittent users (24.56 %) were not significantly different from non-users (p = .092). Nicotine dependence moderated the results such that among smokers with low nicotine dependence, those who used e-cigarettes (intermittently or daily) were less likely to quit than non-users; these differences were not significant among those with high nicotine dependence. Post hoc analyses indicated that initiating daily e-cigarette use after baseline, but not daily e-cigarette use at baseline, was associated with lower odds of cessation.

Conclusions: Daily e-cig use may be associated with lower odds of quitting smoking among treatment-seeking smokers, particularly among those with lower nicotine dependence and who initiate daily use after beginning an intervention.

Keywords: Cigarette smoking; Electronic cigarettes; Smoking; Smoking cessation.

Publication types

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

MeSH terms

  • Adult
  • Behavior Therapy
  • Electronic Nicotine Delivery Systems*
  • Health Behavior
  • Humans
  • Male
  • Middle Aged
  • Prevalence
  • Smokers
  • Smoking / epidemiology
  • Smoking Cessation / methods*
  • Surveys and Questionnaires
  • Tobacco Products
  • Tobacco Smoking
  • Tobacco Use Disorder / epidemiology*
  • Tobacco Use Disorder / therapy
  • Vaping / epidemiology*