E-Cigarettes may help quit smoking but relapse rate high: JAMA

While E-Cigarette use appears to be associated with a reduction in the smoking level and an increase in smoking cessation attempts, E-Cigarette users may have a higher rate of smoking relapse, revealed a study published in JAMA.

Smoking is tied to a spectrum of health hazards such as cancer and cardiovascular disease. There have been a lot of initiatives taken to help smokers quit this dangerous addiction. One such initiative is E-Cigarette. E-Cigarettes or electronic nicotine delivery systems, are considered to be less harmful than conventional cigarettes and are believed to help in smoking cessation but its effectiveness as a cessation aid is uncertain

The present study aimed at ascertaining the association of regular EC use with the number of cigarettes smoked per day, smoking cessation among current smokers, and smoking relapse among former smokers.

The authors conducted a CONSTANCES (Consultants des Centres d ’Examens de Santé) cohort study, based in France that began recruiting participants January 6, 2012, and is currently ongoing. Participants were enrolled in CONSTANCES through 2015, and included 5400 smokers (average follow-up of 23.4 [9.3] months) and 2025 former smokers (average follow-up of 22.1 [8.6] months) at baseline who quit smoking in 2010, the year in which ECs were introduced in France, or afterward. Analyses were performed from February 8, 2017, to October 15, 2018.

Main outcomes assessed in this study were: The association between EC use and the number of cigarettes smoked during the follow-up was studied using mixed regression models. The likelihood of smoking cessation was studied using Poisson regression models with robust sandwich variance estimators. The association between EC use and smoking relapse among former smokers was studied using Cox proportional hazards regression models. All statistical analyses were adjusted for sociodemographic characteristics, duration of follow-up, and smoking characteristics.

Key findings

• Among the 5400 daily smokers (2906 women and 2494 men; average age, 44.9 [12.4] years), regular EC use was associated with a significantly higher decrease in the number of cigarettes smoked per day compared with daily smokers who did not use ECs, as well as a higher adjusted relative risk of smoking cessation.


• At the same time, among the 2025 former smokers (1004 women and 1021 men; average age, 43.6 [12.1] years), EC use was associated with an increase in the rate of smoking relapse among former smokers.

To conclude the study the authors wrote: "This study’s findings suggest that, among adult smokers, EC use appears to be associated with a decrease in smoking level and an increase in smoking cessation attempts but also with an increase in the level of smoking relapse in the general population after approximately 2 years of follow-up."

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doi:10.1001/jamainternmed.2019.1483