Association of electronic cigarette vaping and subsequent smoking relapse among former smokers

• Published in: Drug and alcohol dependence 2019-06, Vol.199, p.10-17
• Main Authors: Dai, Hongying, Leventhal, Adam M.
• Format: Article
• Language: English
• Subjects: Adjustment; Adolescent; Adult; Adults; Aged; Associations; Cigarette smoking; Cigarettes; Cohort Studies; Correlation analysis; E-Cigarettes; Electronic cigarettes; Electronic Nicotine Delivery Systems; Female; Flammability; Follow-Up Studies; Humans; Longitudinal Studies; Male; Middle Aged; PATH study; Quit smoking; Recurrence; Relapse; Smokers - psychology; Smoking; Smoking cessation; Smoking Cessation - methods; Smoking Cessation - psychology; Smoking relapse; Surveys and Questionnaires; Tobacco; Vaping; Vaping - psychology; Vaping - trends; Young Adult
• ISSN: 0376-8716; 1879-0046
• DOI: 10.1016/j.drugalcdep.2019.01.043

•E-Cigarette use and subsequent smoking relapse among former smokers were examined.•Vaping was associated with smoking relapse at follow-up among long-term quitters.•Further studies are needed to evaluate whether this association is causal. Former combustible cigarette smokers who vape e-cigarettes after quitting smoking may experience health benefits if post-quit vaping prevents smoking relapse. Former combustible cigarette smokers aged >18 that were recent (quit ≤ 12 months) or long-term (quit > 12 months) quitters at baseline were re-surveyed at 1-year follow-up in the Population Assessment of Tobacco and Health (PATH) U.S. nationally-representative longitudinal study. Associations of baseline e-cigarette vaping status (never use, prior use, current occasional use, and current regular use) and smoking relapse (vs. abstinence) at follow-up were estimated. Among recent quitters (N = 884), the prevalence of follow-up smoking relapse was 31.6%, 39.0%, 51.6%, and 31.9% among never (N = 233), prior (N = 399), current occasional (N = 56), and current regular (N = 196) baseline e-cigarette users, respectively. Baseline e-cigarette use was not associated with smoking relapse at follow-up after covariate adjustment. In long-term quitters (n = 3210), follow-up smoking relapse was 1.8%, 10.4%, 9.6%, and 15.0% among never (N = 2479), prior (N = 588), current occasional (N = 45), and current regular (N = 98) baseline e-cigarette users, respectively. Both prior use (AOR = 2.00, CI [1.25–3.20]) and current regular use of e-cigarettes (AOR = 3.77, CI [1.48–9.65]) had higher odds of subsequent smoking relapse as compared to never e-cigarette users after covariate adjustment. Among relapsers, baseline e-cigarette vaping was not associated with smoking frequency or intensity at follow-up. Vaping more than one year after quitting smoking was associated with smoking relapse at 12-month follow-up in a nationally-representative sample. Further studies are needed to evaluate whether this association is causal.