Daily vaping dramatically ups quit rate in heavy smokers not aiming to quit

Since the introduction of electronic cigarettes, or e-cigarettes, to the United States in 2006, intense debate has surrounded the marketing, regulation and use of these nicotine-delivery products. Surprising new research led by Roswell Park Comprehensive Cancer Center has found that adult smokers with no plans to quit are more likely to quit smoking traditional combustible cigarettes if they switch to daily vaping.

The Roswell Park study, published today in JAMA Network Open, used data collected from 2014 to 2019 as part of the Population Assessment of Tobacco and Health (PATH) Study, a long-term study on tobacco use and how it affects the health of youth and adults in the United States.

When the researchers focused their analysis on a select group of 1,600 smokers who initially had no plans to quit and were not using e-cigarettes when the study began, they found that those who subsequently vaped daily experienced eightfold higher odds of quitting traditional cigarettes compared to those who didn't use e-cigarettes at all.

"These findings are paradigm-shifting, because the data suggest that vaping may actually help people who are not actively trying to quit smoking," says Andrew Hyland, Ph.D., Chair of Health Behavior at Roswell Park and scientific lead on the PATH Study. "Most other studies focus exclusively on people who are actively trying to quit smoking, but this study suggests that we may be missing effects of e-cigarettes by not considering this group of smokers with limited intention to stop smoking—a group that is often at the highest risk for poor health outcomes from cigarette smoking."

Overall, only about 6% of all smokers included in the Roswell Park study quit smoking combustible cigarettes completely, but the rates of quitting were significantly higher among those who took up daily e-cigarette use —28% of smokers quit when they started vaping daily. The association between vaping and cigarette quitting held up even after adjusting for underlying characteristics such as educational background, income, gender, ethnicity and the number of cigarettes smoked per day at the beginning of the study.

"While clinical trials show strong evidence that vaping can help people quit smoking, findings from real-world population studies have been mixed," says Karin Kasza, Ph.D., a research scientist in the Department of Health Behavior at Roswell Park and first author of the study. "Our study identified a positive association between daily vaping and cigarette quitting specifically among the segment of smokers who were not planning to quit, consistent with data from clinical trials."

Few studies exploring the potential use of using e-cigarettes as a smoking cessation tool have considered smokers with no motivation or desire to quit. The most recent Roswell Park study calls for greater consideration of smokers who are not planning to quit in order to fully understand the health impact of vaping on the U.S. population.

"We found evidence that the use of e-cigarettes could have a positive impact on this very hard-to-reach group of recalcitrant smokers," says Dr. Hyland. "To truly understand the health impact of vaping on the U.S. population, we need to consider those with no intention to quit."