Divergence in Cigarette Discontinuation Rates by Use of Electronic Nicotine Delivery Systems (ENDS): Longitudinal Findings From the United States PATH Study Waves 1–6

Introduction:
This text provides an analysis of the relationship between cigarette discontinuation rates and electronic nicotine delivery systems (ENDS) use among adults in the United States. The study uses data from the Population Assessment of Tobacco and Health (PATH) Study, spanning from 2013/14 to 2021, to compare trends in cigarette discontinuation rates between ENDS users and non-users. The study controls for the complex study design characteristics and attrition in the PATH Study, ensuring the estimates are representative of the U.S. adult population.

Key Points:

* The study uses data from the PATH Study, a nationally representative longitudinal study of youth and adults in the United States.
* The analysis is conducted on adults aged 21 years and older who smoked cigarettes in the past 30 days and have ENDS use data at baseline and cigarette discontinuation data at follow-up.
* The study uses two approaches for the assessment of ENDS use: at baseline and at follow-up.
* Cigarette discontinuation rates were generally similar between ENDS users and non-users between 2013/14 and 2015/16.
* However, between 2018/19 and 2021, cigarette discontinuation rates were significantly higher among ENDS users compared to non-users.
* The study uses Rao-Scott Design-based F tests and generalized estimating equations (GEEs) logistic regression analyses to test the interactions between ENDS use and linear trends and between ENDS use and nonlinear trends.
* The study finds that there are significant interactions between linear time x ENDS use and cigarette discontinuation rates, as well as between nonlinear time x ENDS use and cigarette discontinuation rates.

Main Message:
The study highlights the importance of understanding the relationship between ENDS use and cigarette discontinuation rates in the context of an expanded ENDS marketplace, new tobacco regulatory actions, and the COVID-19 pandemic. The findings suggest that public health decisions should be informed by research based on the contemporary ENDS marketplace and circumstances. The study also emphasizes the need for further research to identify why cigarette discontinuation rates increased over time more among ENDS users than non-users and to evaluate whether trends varied among subgroups of the population.

Karin A Kasza, Zhiqun Tang, Young Sik Seo, Adam F Benson, MeLisa R Creamer, Kathryn C Edwards, Colm Everard, Joanne T Chang, Yu-Ching Cheng, Babita Das, Olusola Oniyide, Nicole A Tashakkori, Anna-Sophie Weidner, Haijun Xiao, Cassandra Stanton, Heather L Kimmel, Wilson Compton, Andrew Hyland, Divergence in Cigarette Discontinuation Rates by Use of Electronic Nicotine Delivery Systems (ENDS): Longitudinal Findings From the United States PATH Study Waves 1–6, Nicotine & Tobacco Research, Volume 27, Issue 2, February 2025, Pages 236–243, https://doi.org/10.1093/ntr/ntae027