Smokers who try to quit by switching to e-cigarettes do not have more success than those who use other smoking cessation strategies and in fact may be more likely to relapse, researchers found. They reported their study results in Tobacco Control.

Using data from the Population Assessment of Tobacco and Health (PATH) Study, the researchers compared smoking behaviors for 3,578 previous-year smokers who recently attempted to quit and 1,323 recent former smokers from 2017–2019. PATH measured participants’ use of e-cigarettes and other smoking cessation tools as well as their length of successful tobacco abstinence.

Fewer people reported using e-cigarettes as a smoking cessation aid in 2019 compared to 2017, and only 9.9% of those who did successfully maintained cessation for more than one year, a rate comparable to other cessation strategies (e.g., nicotine replacement therapy, pharmaceutical aids, no aids). The researchers also found that 4% of e-cigarette users had switched to a high-nicotine concentration in 2019, a rate nearly double that of 2017 (2.2%). Additionally, nearly 60% of daily e-cigarette users who had quit relapsed by 2019.

“This analysis did not show a cessation benefit from using e-cigarettes either to help a cessation attempt or as a substitute for cigarette smoking,” the researchers concluded. “However, there is evidence that cigarette smokers were starting to use high nicotine e-cigarettes by 2019 and further follow-up in PATH is needed to see whether these changes result in future cessation benefit.”

The U.S. Food and Drug Administration has not approved e-cigarettes as a smoking cessation tool, and the devices’ health risks are similar to those of traditional cigarettes, including the implications of secondhand smoke on others. In its e-cigarettes and vaping position statement, ONS calls for more research and regulation of electronic nicotine delivery systems like e-cigarettes to better understand and prevent their contribution to the global cancer burden. Read the statement and find other resources in ONS’s E-Cigarettes and Vaping Learning Library.