Transition to smoking cessation among dual cigarette and e-cigarette users in the population assessment of tobacco and health study, Waves 3 and 4 (2015-2017)

Introduction: This study evaluated the patterns of smoking cessation at Wave 4 of the Population Assessment of Tobacco and Health (PATH) Study among established cigarette smokers who were also current e-cigarettes users at Wave 3. Methods: We assessed changes in smoking frequency at Wave 4 among established cigarette and e-cigarette users at Wave 3. The demographics of participants were analyzed as well as e-cigarettes device types, number of cigarettes smoked and time from waking up until the first cigarette. Unadjusted and adjusted odds ratios as well as percentage of discontinuing cigarettes use at Wave 4 were calculated for the different categories of dual users. Results: Among dual users at Wave 3, 13.1% quit cigarette smoking at Wave 4, whereas half discontinued ecigarette use and maintained exclusive cigarette smoking. Significant differences in the percentage of smoking cessation were observed across demographic groups - dual users with a bachelor's degree were more likely to quit smoking than dual users who did not finish high school (aOR = 3.06, 95% CI: 1.17-8.00) and smokers aged 25-64 years were less likely to quit smoking than those aged 18-24 years (aOR = 0.49, 95% CI: 0.28-0.86 for smokers aged 25-44 years, and aOR = 0.42, 95% CI: 0.20-0.87 for those aged 45-64). Dual users who smoked more than 15 cigarettes per day were significantly less likely to stop smoking (aOR = 0.38, 95% CI: 0.17-0.88). Conclusion: E-cigarettes have the potential to aid in smoking cessation. Questions remain as to whether dual use of e-cigarettes and cigarettes should be encouraged as a transitional phase on the path to smoking cessation.