e-Cigs' Promise as Effective Quitting Tool Up in Smoke

Caroline Cassels

March 24, 2014

The potential of electronic cigarettes (e-cigarettes) as an effective quit-smoking tool has been extinguished, new research shows.

Results from a longitudinal analysis of e-cigarette use and smoking cessation in a national sample of 1549 participants showed that baseline e-cigarette use was not associated with change in cigarette consumption at 1 year.

"[W]e found that e-cigarette use by smokers was not followed by greater rates of quitting or by reduction in cigarette consumption 1 year later," the authors, led by Rachel A. Grana, PhD, MPH, University of California, San Francisco, write.

The study was published online March 24 in JAMA Internal Medicine.

Contributor to Nicotine Addiction

These findings mirror those of another recent study of e-cigarettes conducted in a pediatric population and reported by Medscape Medical News at that time, which showed that e-cigarettes not only did not deter smoking in teens but that they actually contributed to nicotine addiction.

Furthermore, the investigators cite another recent study published in the American Journal of Preventive Medicine that also showed that e-cigarette use was not followed by greater rates of quitting or by reduction in cigarette consumption 1 year later.

According to investigators, the same study shows that 85% of smokers who used e-cigarettes reported that they used them to quit.

For the current study, the investigators analyzed data from current smokers recruited from the Knowledge Networks probability-based Web-enabled panel who completed baseline and follow-up surveys in November 2011 and again in November 2012.

The final analysis was based on data from 949 participants. A total of 88 smokers used e-cigarettes at baseline.

The investigators found that significantly more women, younger adults, and individuals with less education used e-cigarettes. The results also revealed that a greater portion of e-cigarette users reported smoking their first cigarette of the day less than 30 minutes after waking compared with nonusers (69.0% vs 57.9%; P = .046). In addition, baseline e-cigarette use was not significantly associated with greater intention to quit smoking (P = .09).

Although baseline e-cigarette use did not predict quitting at 1 year, 2 other factors ― intention to quit (odds ratio [OR], 5.59; 95% confidence interval [CI], 2.41 - 12.98) and the number of cigarettes smoked per day (OR, 0.97; 95% CI, 0.94 - 0.99) ― significantly predicted quit status.

"[O]ur data add to the current evidence that e-cigarettes may not increase rates of smoking cessation. Regulations should prohibit advertising claiming or suggesting that e-cigarettes are effective smoking cessation devices until claims are supported by scientific evidence," the investigators write.

Need for FDA Regulation

In a related editor's note, Mitchell H. Katz, MD, deputy editor of JAMA Internal Medicine, said the study results "increase the weight of evidence indicating that e-cigarettes are not associated with higher rates of smoking cessation."

In addition, Dr. Katz called for regulation of e-cigarettes by the US Food and Drug Administration and agreed with the authors' assertion that "sellers of e-cigarettes should not be able to advertise them as smoking cessation devices without sufficient evidence that they are effective for this indication."

The authors and Dr. Katz report no relevant financial relationships.

JAMA Intern Med. Published online March 24, 2014. Abstract, Editorial


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