Concurrent E-Cigarette Use During Tobacco Dependence Treatment in Primary Care Settings: Association With Smoking Cessation at Three and Six Months

Introduction:
This text is a summary of a scientific study on the use of electronic cigarettes (e-cigarettes) as a smoking cessation aid. The study analyzed data from a large cohort of smokers enrolled in a standard evidence-based smoking cessation treatment program that included both nicotine replacement therapy (NRT) and in-person behavioral counseling free of charge for up to 6 months, offered through primary care clinics in Ontario, Canada. The study aimed to determine the association between reported e-cigarette use and smoking cessation at 3 and 6 months following enrollment in the smoking cessation treatment program.

Key Points:

* The study included 6526 participants who completed a 3-month follow-up and 2349 who completed a 6-month follow-up.
* 18.1% of the participants reported using an e-cigarette in the last 3 months at the 3-month follow-up and 12.4% at the 6-month follow-up.
* The majority of e-cigarette users reported using e-cigarettes to help them quit smoking, reduce their smoking, or remain smoke free.
* E-cigarette users had lower quit rates at both 3-month (27.0% vs. 36.5%) and 6-month (26.3% vs. 42.0%) follow-ups compared to nonusers.
* The study controlled for potential confounders such as age, gender, importance of quitting smoking, confidence in the ability to quit smoking, education, employment status, and past diagnosis of mental illness.
* E-cigarette users who reported using e-cigarettes as a smoking cessation tool had significantly lower quit rates compared to nonusers at both 3-month (25.6% vs. 36.5%) and 6-month (23.7% vs. 42.0%) follow-ups.
* There were no significant differences in the number of cigarettes smoked per day in daily smokers or current NRT use at the 6-month follow-up between e-cigarette users and nonusers.

Main Message:
The main message of this study is that concurrent e-cigarette use during a quit attempt utilizing cost-free evidence-based treatment (NRT plus behavioral counseling) does not confer any added benefit and may harm cessation attempts. The findings suggest that smokers who use e-cigarettes as a smoking cessation aid may have poorer quit outcomes compared to those who do not use e-cigarettes. Therefore, smokers should consider other evidence-based smoking cessation methods before using e-cigarettes.

Zawertailo, Laurie, Dmytro Pavlov, Anna Ivanova, Ginnie Ng, Dolly Baliunas, and Peter Selby. “Concurrent E-Cigarette Use During Tobacco Dependence Treatment in Primary Care Settings: Association With Smoking Cessation at Three and Six Months.” Nicotine & Tobacco Research 19, no. 2 (February 2017): 183–89. https://doi.org/10.1093/ntr/ntw218.