E-cigarettes could hinder smoking cessation in some groups, research shows

More research is needed to determine whether regular use of e-cigarettes aids or hinders smoking cessation, researchers have concluded after a prospective study showed that patients who used an e-cigarette after discharge from hospital were less likely to be abstinent after six months than smokers who did not use e-cigarettes^[1]
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The researchers carried out a secondary data analysis of a large randomised controlled trial that enrolled 1,357 hospitalised cigarette smokers who planned to quit smoking and compared a post-discharge smoking cessation intervention versus standard care.

The intervention group received a free supply of their choice of Food and Drug Administration (FDA)-approved cessation medication and five automated telephone calls over 90 days to encourage participants to remain abstinent. In the standard care group, participants were advised to call a free telephone quit-line and received an individualised post-discharge medication recommendation.

Abstinence and current use of smoking cessation treatments were assessed one, three and six months after discharge.

The researchers found that 28% of participants who planned to quit smoking and were advised to use smoking cessation treatment reported using an e-cigarette in the three months after discharge. Use of e-cigarettes was found to be intermittent or at the same time as another smoking cessation treatment.

Smokers who used an e-cigarette were less likely to be abstinent after six months than smokers who did not (10.1% vs. 26.6%; risk difference, 16.5% [95% Confidence Interval, 23.3% to 9.6%]).

The authors suggested that smokers with easy access to cessation aids may have initiated e-cigarette use when conventional aids failed. If so, e-cigarette users in the study might represent a subgroup who have more difficulty quitting.

The authors said that it might still be possible that e-cigarettes can promote tobacco cessation if used regularly and as a complete replacement for cigarettes, but further research is needed.