E-Cigarettes May Help People Quit Smoking

Credit: Adobe Stock/mbruxelle

Short-term use of both cigarettes and e-cigarettes was associated with better long-term quitting outcomes, according to research published in Nicotine & Tobacco Research.

“The sooner smokers quit, the better, but for those who find it difficult to stop smoking abruptly, vaping can help with doing it gradually over time,” said lead investigator Francesca Pesola, Ph.D., senior lecturer in Statistics at Queen Mary University of London.

Many people turn to e-cigarettes (also called vapes) to help them quit smoking, but there is still limited guidance on how to use them most effectively.

This large study followed 886 adults from the Trial of Electronic Cigarettes (TEC) for one year to better understand how different patterns of e-cigarette use compared with traditional nicotine replacement therapy (NRT), such as patches or gum, when it comes to quitting smoking or cutting back.

One key finding was that flavor choice mattered. People who used tobacco-flavored e-cigarettes were less likely to quit smoking compared with those who used non-tobacco flavors, such as fruit. In fact, non-tobacco flavors were more popular overall and were linked to better quit outcomes (36.9% vs 20.2%, respectively). This suggests that flavors may play a role in helping people fully switch away from cigarettes.

The study also found that people who used e-cigarettes tended to gradually lower the nicotine strength they used over time. This is important because it suggests many users naturally taper their nicotine intake rather than increasing it.

When it came to cravings, people who successfully quit smoking and used e-cigarettes reported lower urges to smoke than those who quit using nicotine patches or gum, especially during the first month, when relapse risk is high. This indicates that e-cigarettes may be more effective than NRT at managing early cravings for some people.

Another important takeaway involved dual use, meaning people who used both cigarettes and e-cigarettes at the same time. While dual use is often viewed negatively, this study found that people who were dual users early on were more likely to quit smoking later than those who continued smoking cigarettes alone. Dual users were also more likely to significantly reduce how many cigarettes they smoked over the long term, with an average of 50% reduced smoke intake at 1 year.

Overall, the findings suggest that e-cigarettes, especially when using non-tobacco flavors, may help reduce cravings, support smoking reduction and increase the chances of quitting altogether.

However, investigators pointed to some limitations to keep in mind. This study can show links between e-cigarette use and quitting smoking, but it cannot prove that e-cigarettes caused people to quit. Participants chose whether or not to use e-cigarettes themselves, which means unmeasured factors, including motivation, may have influenced the results. While the investigators adjusted for some differences like age, sex and level of nicotine dependence, other factors could still explain some of the findings. The team noted that larger, randomized studies are needed to confirm these results.

For patients considering e-cigarettes as a quitting aid, this study offers reassurance that gradual change, including short-term dual use, can still lead to meaningful progress.

“Smokers (and clinicians) sometimes believe that if smokers do not manage to stop smoking soon after starting vaping, they should stop using e-cigarettes to avoid ‘dual use,'” said co-lead investigator Peter Hajek, Ph.D., professor of clinical psychology and director of the Health and Lifestyle Research Unit at Queen Mary University of London. “These results show that dual use promotes genuine harm reduction and that it can be a useful step to stopping smoking altogether.”