Real-world effectiveness of e-cigarettes when used to aid smoking cessation: a cross-sectional population study.
OBJECTIVE
Electronic cigarettes (e-cigarettes) are rapidly increasing in popularity. Two randomized controlled trials have suggested that e-cigarettes can aid smoking cessation, but there are many factors that could influence their real-world effectiveness. This study aimed to assess, using an established methodology, the effectiveness of e-cigarettes when used to aid smoking cessation compared with nicotine replacement therapy (NRT) bought over-the-counter and with unaided quitting in the general population.


METHODS
A large cross-sectional survey of a representative sample of the English population.


METHODS
The study included 5863 adults who had smoked within the previous 12 months and made at least one quit attempt during that period with either an e-cigarette only (n = 464), NRT bought over-the-counter only (n = 1922) or no aid in their most recent quit attempt (n = 3477).


METHODS
The primary outcome was self-reported abstinence up to the time of the survey, adjusted for key potential confounders including nicotine dependence.


RESULTS
E-cigarette users were more likely to report abstinence than either those who used NRT bought over-the-counter [odds ratio (OR) = 2.23, 95% confidence interval (CI) = 1.70-2.93, 20.0 versus 10.1%] or no aid (OR = 1.38, 95% CI = 1.08-1.76, 20.0 versus 15.4%). The adjusted odds of non-smoking in users of e-cigarettes were 1.63 (95% CI = 1.17-2.27) times higher compared with users of NRT bought over-the-counter and 1.61 (95% CI = 1.19-2.18) times higher compared with those using no aid.


CONCLUSIONS
Among smokers who have attempted to stop without professional support, those who use e-cigarettes are more likely to report continued abstinence than those who used a licensed NRT product bought over-the-counter or no aid to cessation. This difference persists after adjusting for a range of smoker characteristics such as nicotine dependence.
Cancer Research UK Health Behaviour Research Centre, University College London, London, UK; Department of Clinical, Educational and Health Psychology, University College London, London, UK.
Jamie
J
Brown
Emma
E
Beard
Daniel
D
Kotz
Susan
S
Michie
Robert
R
West
D000328:Adult; D003430:Cross-Sectional Studies; D066300:Electronic Nicotine Delivery Systems / Q000706:statistics & numerical data*; D004739:England; D005260:Female; D006801:Humans; D008297:Male; D012907:Smoking / Q000628:therapy*; D016540:Smoking Cessation / Q000379:methods* / Q000706:statistics & numerical data; D061485:Tobacco Use Cessation Devices / Q000706:statistics & numerical data*; D016896:Treatment Outcome
Cessation; NRT; cross-sectional population survey; e-cigarettes; electronic cigarettes; nicotine replacement therapy; quitting; smoking