• Home
  • Store
    • Newsletter Subscriptions
    • Multimedia Subscriptions
    • Books
    • eBooks
    • ABPN SA Courses
  • CME Center
  • Multimedia
    • Podcast
    • Webinars
    • Blog
  • Newsletters
    • General Psychiatry
    • Child Psychiatry
    • Addiction Treatment
    • Hospital Psychiatry
    • Geriatric Psychiatry
    • Psychotherapy and Social Work
  • Log In
  • Register
  • Welcome
  • Sign Out
  • Subscribe
Home » E-Cigarettes and Relapse to Cigarette Smoking

E-Cigarettes and Relapse to Cigarette Smoking

July 1, 2022
Noah Capurso, MD
From The Carlat Addiction Treatment Report
Issue Links: Editorial Information | PDF of Issue

Noah Capurso, MD. Dr. Capurso, author for this educational activity, has no relevant financial relationship(s) with ineligible companies to disclose.

REVIEW OF: Pierce JP et al, JAMA Network Open 2021;4(10):e2128810

STUDY TYPE: Cohort study

Mounting evidence suggests that ­e-cigarettes are effective for smoking cessation—nearly twice as effective as nicotine replacement therapy (see CATR May/Jun 2020 for a review of a prominent randomized controlled trial). While health authorities in some countries, such as the UK, now recommend e-cigarettes for smoking cessation, US entities like the FDA and the CDC have been far more cautious, arguing that the evidence is still preliminary and that the potential harms of e-cigarettes are not fully understood.

Recently, a large survey of US cigarette smokers added a note of caution to advocacy of e-cigarettes. While most clinical trials have focused on e-cigarettes as smoking cessation aids, in this survey researchers asked a different question: Are e-cigarettes a viable strategy to prevent return to cigarette smoking once someone has quit?

Researchers used data from the US Population Assessment of Tobacco and Health study, a large longitudinal survey of a nationally representative group of cigarette smokers. Participants were surveyed about their cigarette smoking habits at three time points—baseline, follow-up at one year, and follow-up at two years. Researchers examined the participants who had quit cigarette smoking by the time of the first follow-up and determined which strategy they had used to do so: remaining tobacco free, using an e-cigarette, or switching to some other tobacco product. For the purposes of this survey, participants who used e-cigarettes were not counted as tobacco free, a choice made to adhere to USDA definitions (Munajo M, Nicotine Tob Res 2019;21(3):267).

Of the 13,604 participants who filled out all three surveys, 9.4% (n = 1228) had quit cigarette smoking between the baseline survey and the first follow-up a year later. Of these recent former cigarette smokers, 62.9% had used a completely tobacco-free strategy, 22.8% had switched to e-cigarettes, 10.5% had switched to cigars, and 9.7% had switched to some other form of tobacco. A handful of patients used multiple forms of tobacco, which is why the percentages add up to more than 100%.

As expected, many of the participants who had quit cigarette smoking at the first follow-up had returned to cigarettes by the second follow-up a year later. However, researchers did find a difference between quit strategies; namely, tobacco-free participants fared better than those who had switched to e-cigarettes or another form of tobacco. The comparative quit rates at the two-year mark were 50.5% for the tobacco-free group, 41.6% for participants who used e-cigarettes, and 40.7% for those who used combustible tobacco products such as cigars, cigarillos, pipes, or hookahs. Overall, the rate of returning to cigarette smoking was 8.5% higher among those who had switched to ­e-cigarettes or another tobacco product compared to those who stayed tobacco free.

CARLAT TAKE

Take these results with a pinch of salt. Unlike the trials demonstrating the efficacy of e-cigarettes for smoking cessation, this was not a randomized clinical trial and there was no way to verify participant self-reports. Nonetheless, the results suggest that tobacco-free strategies may be more effective in the long term over e-cigarettes. We await a clinical trial testing this hypothesis before drawing definitive conclusions.

KEYWORDS e cigarettes smoking cessation vaping
    Qa1 noah capurso headshot 150x150
    Noah Capurso, MD

    Xylazine: An Emerging Threat in the Opioid Overdose Epidemic

    More from this author
    www.thecarlatreport.com
    Issue Date: July 1, 2022
    SUBSCRIBE NOW
    Table Of Contents
    Supervised Drug Consumption
    Addiction and Borderline Personality Disorder
    Should Prolonged Abstinence From Alcohol Be Required Before Liver Transplant?
    Does Pioglitazone Lead to Reduced Alcohol Use?
    E-Cigarettes and Relapse to Cigarette Smoking
    Learning Objectives, Personality Disorders and Addiction, CATR, July/August 2022
    CME Post-Test - Personality Disorders and Addiction, CATR, July/August 2022
    DOWNLOAD NOW
    Featured Book
    • MFB7e_cover_sm.png

      Medication Fact Book for Psychiatric Practice, Seventh Edition (2024)

      The updated 2024 reference guide covering the most commonly prescribed medications in psychiatry.
      READ MORE
    Featured Video
    • therapist_canstockphoto9201097.jpg
      General Psychiatry

      Using SAMe In Clinical Practice with Garrett Rossi, MD

      Read More
    Featured Podcast
    • shutterstock_495683782.jpg
      General Psychiatry

      The Other Freud 1

      Sigmund Freud’s theories are challenged by his granddaughter, Sophie Freud.



      Listen now
    Recommended
    • Approaches to Autism Intervention

      January 31, 2022
      canstockphoto2240982_child-bubbles_thumb.jpg
    • Currently Available Cannabis Products

      September 1, 2022
    • Interpreting Assessment Discrepancies from Multiple Sources

      October 17, 2022
      ChildAssessment.png
    • Approaches to Autism Intervention

      January 31, 2022
      canstockphoto2240982_child-bubbles_thumb.jpg
    • Currently Available Cannabis Products

      September 1, 2022
    • Interpreting Assessment Discrepancies from Multiple Sources

      October 17, 2022
      ChildAssessment.png
    • Approaches to Autism Intervention

      January 31, 2022
      canstockphoto2240982_child-bubbles_thumb.jpg
    • Currently Available Cannabis Products

      September 1, 2022
    • Interpreting Assessment Discrepancies from Multiple Sources

      October 17, 2022
      ChildAssessment.png

    About

    • About Us
    • CME Center
    • FAQ
    • Contact Us

    Shop Online

    • Newsletters
    • Multimedia Subscriptions
    • Books
    • eBooks
    • ABPN Self-Assessment Courses

    Newsletters

    • The Carlat Psychiatry Report
    • The Carlat Child Psychiatry Report
    • The Carlat Addiction Treatment Report
    • The Carlat Hospital Psychiatry Report
    • The Carlat Geriatric Psychiatry Report
    • The Carlat Psychotherapy Report

    Contact

    info@thecarlatreport.com

    866-348-9279

    PO Box 626, Newburyport MA 01950

    Follow Us

    Please see our Terms and Conditions, Privacy Policy, Subscription Agreement, Use of Cookies, and Hardware/Software Requirements to view our website.

    © 2023 Carlat Publishing, LLC and Affiliates, All Rights Reserved.