E-cigarette initiation and associated changes in smoking cessation and reduction: the Population Assessment of Tobacco and Health Study, 2013–2015

Introduction:
This text is a research paper that investigates the association between e-cigarette initiation and cigarette smoking cessation among adults in a nationally representative cohort. The study uses data from the Population Assessment of Tobacco and Health (PATH) Study and employs logistic regression models to estimate the odds of cigarette cessation and substantial reduction in cigarette consumption among e-cigarette initiators. The paper also includes various sensitivity analyses to test the robustness of the findings.

Key points:

* The study sample consists of cigarette smokers who were not current e-cigarette users at wave 1 of the PATH Study.
* Among cigarette smokers who were not current e-cigarette users at wave 1, 6.90% individuals quit smoking cigarettes for at least 30 days.
* Cigarette smokers who initiated daily e-cigarette use had 7.88 (95% CI 4.45 to 13.95) times the odds of quitting cigarette smoking compared with e-cigarette non-users.
* E-cigarette experimenters showed reduced odds of quitting cigarette smoking, while individuals who were everyday smokers had decreased odds of achieving 30-day cigarette cessation.
* Cigarette smokers who began using e-cigarettes every day and did not quit smoking cigarettes had 5.70 times the odds of reducing their daily cigarette use by at least 50%.
* The linear regression model showed that cigarette smokers who began using e-cigarettes every day and did not quit smoking cigarettes reduced their average daily cigarette use by 5.60 (95% CI 3.52 to 7.68) more cigarettes than the reference group of e-cigarette non-users.
* Sensitivity analyses showed that collapsing all e-cigarette use into a single category substantially attenuated the association between e-cigarette use and 30-day cigarette cessation.

Main message:
The main message of the text is that e-cigarette initiation, particularly daily use, is associated with increased odds of cigarette cessation and substantial reduction in cigarette consumption among adults. The study provides evidence on the temporal relationship between e-cigarette initiation and cigarette smoking cessation, which is a vital aspect missing from many prior studies. The findings suggest that frequent e-cigarette use makes a difference in the odds of cigarette cessation/reduction, and e-cigarette product characteristics play a role in cigarette cessation. However, the study also highlights the need for further research on the long-term health consequences of e-cigarette and dual product use.

Berry, Kaitlyn M, Lindsay M Reynolds, Jason M Collins, Michael B Siegel, Jessica L Fetterman, Naomi M Hamburg, Aruni Bhatnagar, Emelia J Benjamin, and Andrew Stokes. “E-Cigarette Initiation and Associated Changes in Smoking Cessation and Reduction: The Population Assessment of Tobacco and Health Study, 2013–2015.” Tobacco Control, March 24, 2018, tobaccocontrol-2017-054108. https://doi.org/10.1136/tobaccocontrol-2017-054108.