Brief reportElectronic Cigarettes As a Smoking-Cessation Tool: Results from an Online Survey
Introduction
Electronic cigarettes (e-cigarettes) are battery-powered devices that deliver nicotine without any combustion or smoke. Use and awareness of e-cigarettes has dramatically increased over the past 3 years.1, 2, 3 Ayers et al.,3 in this issue of the American Journal of Preventive Medicine, report that Internet searchers for e-cigarettes in the U.S. now exceed those for any other smoking alternative, nicotine replacement, or smoking-cessation product. Although e-cigarettes have generated much support from dedicated users, little is known about the efficacy of the device as a smoking-cessation tool.
Most smoking-cessation methods focus on one component of smoking: nicotine addiction. However, even with the assistance of medications that treat nicotine addiction, the success rate for quitting remains low. Based on a Cochrane review of seven studies4, 5, 6, 7, 8, 9 that measured smoking cessation using nicotine replacement therapy (NRT), the average 6-month point prevalence of smoking abstinence is only 17.8%, and the 6-month point prevalence of smoking abstinence in the pooled data from these studies is only 11.9%.
Several studies10, 11 have suggested that physical and behavioral stimuli—such as merely holding a cigarette—can reduce the craving to smoke, even in the absence of nicotine delivery. Given that both nicotine and smoking-related cues appear to influence cigarette craving, e-cigarettes may present a unique opportunity to promote smoking cessation. Two preliminary studies12, 13, 14 provide evidence that e-cigarette use suppresses the urge to smoke.
Results from two recent surveys15, 16 suggest that e-cigarettes may be effective in helping smokers quit. However, both of these surveys relied on convenience samples of e-cigarette users.
This paper reports the results of a survey conducted using a non-convenience sampling frame. Compared with previous studies, which used convenience samples, this survey is based on a sample of all first-time purchasers of a particular brand of e-cigarettes.
Section snippets
Methods
An anonymous Internet-based, cross-sectional survey was conducted among a cohort of first-time purchasers of e-cigarettes from a leading e-cigarette distributor to determine the effectiveness of e-cigarettes for smoking cessation.
Participant Characteristics and Smoking History
There were more men (71.5%) than women (28.5%) in the study (Table 1). The majority of respondents had smoked for 6 or more years (81.1%), and nearly two thirds (64.7%) of participants reported having made three or more previous quit attempts.
Cessation or Reduction of Tobacco After E-Cigarette Use
More than two thirds of respondents (66.8%) reported having reduced the number of tobacco cigarettes they smoked per day after trying e-cigarettes, and nearly half (49.3%) reduced their nicotine use (Table 1). Nearly half (48.8%) of respondents indicated
Discussion
The primary finding was a 6-month point prevalence of smoking abstinence among the e-cigarette users in the sample of 31.0%. This compares favorably to the average 6-month point prevalence of smoking abstinence of 17.8% in prior studies and to the 6-month point prevalence of smoking abstinence of 11.9% in the pooled data from these studies.4, 5, 6, 7, 8, 9
Of those respondents who were not smoking at the 6-month point, more than one third (34.3%) were also nicotine-free. This suggests that
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