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Student Research explained

E-cigarettes: friend or foe?

BMJ 2019; 364 doi: https://doi.org/10.1136/sbmj.j5150 (Published 08 January 2019) Cite this as: BMJ 2019;364:j5150
  1. Neil Chanchlani, year 2 specialist trainee in paediatrics
  1. Royal Free London NHS Foundation Trust, London, UK
  2. nchanchlani@doctors.org.uk

Use of e-cigarettes is associated with population level changes in smoking cessation

The paper

E-cigarette use and associated changes in population smoking cessation: evidence from US current population surveys by Shu-Hong Zhu, et al (BMJ 2017;358:j3262).

Objective—To examine whether the increase in use of electronic cigarettes (e-cigarettes) in the US, which became noticeable around 2010 and had increased dramatically by 2014, was associated with a change in the overall smoking cessation rate at population level.

Design—Population surveys with nationally representative samples.

Setting—Five US Current Population Survey-Tobacco Use Supplements (CPS-TUS) in 2001-02, 2003, 2006-07, 2010-11, and 2014-15.

Participants—Data on e-cigarette use were obtained from the total sample of the 2014-15 CPS-TUS (n=161 054). Smoking cessation rates were obtained from those who reported smoking cigarettes 12 months before the survey (n=23 270). Rates from the 2014-15 CPS-TUS were then compared with those from the 2010-11 CPS-TUS (n=27 280) and those from three other previous surveys.

Main outcome measures—The rate of attempts to quit cigarette smoking and the rate of successfully quitting smoking, defined as having quit smoking for at least three months.

Results—Of 161 054 respondents to the 2014-15 survey, 22 548 were current smokers and 2136 recent quitters. Among them, 38.2% of current smokers and 49.3% of recent quitters had tried e-cigarettes, and 11.5% and 19.0% used them currently (every day or some days). E-cigarette users were more likely than non-users to attempt to quit smoking, 65.1% v 40.1% (change=25.0%, 95% confidence interval 23.2% to 26.9%), and more likely to succeed in quitting, 8.2% v 4.8% (3.5%, 2.5% to 4.5%). The overall population cessation rate for 2014-15 was significantly higher than that for 2010-11, 5.6% v 4.5% (1.1%, 0.6% to 1.5%), and higher than those for all other survey years (range 4.3­-4.5%).

Conclusion—The substantial increase in e-cigarette use among US adult smokers was associated with a statistically significant …

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