Association Between Electronic Cigarette Use and Smoking Reduction in France.

Introduction:
This text provides an analysis of a study on the association between electronic cigarette (EC) use and smoking patterns in a large population-based cohort. The study investigates the relationship between EC use and smoking reduction or quitting, as well as the impact of EC use on smoking relapse among former smokers. The study aims to contribute to the understanding of the role of ECs in smoking cessation and reduction.

Key Points:

* The study was based on the French CONSTANCES cohort and included 5,400 current smokers and 2,025 former smokers.
* The study found that EC use was associated with a reduction in smoking level and an increased probability of smoking cessation among current smokers.
* However, the study also observed that over time, EC users who quit tobacco tended to relapse to smoking more frequently than non-users.
* Participants’ nicotine dependence was not measured, but the study controlled for the number of cigarettes smoked per day and pack-years of smoking.
* The duration of follow-up was on average 23 months, and participants reported current EC use and date of initiation.
* The study found that former smokers who used ECs were more likely to relapse to smoking, with the hazard ratio decreasing over time.
* The study's main contribution is the finding of an elevated rate of smoking relapse among former smokers who use an EC.

Main Message:
The study suggests that while EC use can help individuals reduce their smoking levels and initiate smoking cessation, it is not clear whether it leads to complete long-term cessation. The study also highlights the importance of considering the potential risks associated with EC use, particularly the risk of smoking relapse among former smokers. Further research is needed to better understand the long-term effects of EC use on smoking cessation and reduction.

Gomajee R, El-Khoury F, Goldberg M, et al. Association Between Electronic Cigarette Use and Smoking Reduction in France. JAMA internal medicine. 2019;179(9):1193-1200. doi:10.1001/jamainternmed.2019.1483