Role of e-cigarettes and pharmacotherapy during attempts to quit cigarette smoking: The PATH Study 2013-16

John P. Pierce, Tarik Benmarhnia, Ruifeng Chen, Martha White, David B. Abrams, Bridget K. Ambrose, Carlos Blanco, Nicolette Borek, Kelvin Choi, Blair Coleman, Wilson M. Compton, K. Michael Cummings, Cristine D. Delnevo, Tara Elton-Marshall, Maciej L. Goniewicz, Shannon Gravely, Geoffrey T. Fong, Dorothy Hatsukami, James Henrie, Karin A. KaszaSheila Kealey, Heather L. Kimmel, Jean Limpert, Raymond S. Niaura, Carolina Ramôa, Eva Sharma, Marushka L. Silveira, Cassandra A. Stanton, Michael B. Steinberg, Ethel Taylor, Maansi Bansal-Travers, Dennis R. Trinidad, Lisa D. Gardner, Andrew Hyland, Samir Soneji, Karen Messer

Research output: Contribution to journalArticlepeer-review


Background More smokers report using e-cigarettes to help them quit than FDA-approved pharmacotherapy. Objective To assess the association of e-cigarettes with future abstinence from cigarette and tobacco use. Design Cohort study of US sample, with annual follow-up. Participants US adult (ages 18+) daily cigarette smokers identified at Wave 1 (W1; 2013-14) of the PATH Study, who reported a quit attempt before W2 and completed W3 (n = 2443). Exposures Use of e-cigarettes, pharmacotherapy (including nicotine replacement therapy), or no product for last quit attempt (LQA), and current daily e-cigarette use at W2. Analysis Propensity score matching (PSM) of groups using different methods to quit. Outcome measures 12+ months abstinence at W3 from cigarettes and from all tobacco (including e-cigarettes). 30+ days abstinence at W3 was a secondary outcome. Results Among daily smokers with an LQA, 23.5% used e-cigarettes, 19.3% used pharmacotherapy only (including NRT) and 57.2% used no product. Cigarette abstinence for 12+ months at W3 was ~10% in each group. Half of the cigarette abstainers in the e-cigarette group were using e-cigarettes at W3. Different methods to help quitting had statistically comparable 12+ month cigarette abstinence at W3 (e-cigarettes vs no product: Risk Difference (RD) = 0.01, 95% CI: -0.04 to 0.06; e-cigarettes vs pharmacotherapy: RD = 0.02, 95% CI:-0.04 to 0.09). Likewise, daily e-cigarette users at W2 did not show a cessation benefit over comparable no-e-cigarette users and this finding was robust to sensitivity analyses. Abstinence for 30+ days at W3 was also similar across products. Limitations The frequency of e-cigarette use during the LQA was not assessed, nor was it possible to assess continuous abstinence from the LQA. Conclusion Among US daily smokers who quit cigarettes in 2014-15, use of e-cigarettes in that attempt compared to approved cessation aids or no products showed similar abstinence rates 1-2 years later.

Original languageEnglish (US)
Article numbere0237938
JournalPloS one
Issue number9
StatePublished - Sep 2020


  • Adolescent
  • Adult
  • Behavior Therapy
  • Cigarette Smoking/adverse effects
  • Drug Therapy/statistics & numerical data
  • Electronic Nicotine Delivery Systems/statistics & numerical data
  • Female
  • Humans
  • Incidence
  • Longitudinal Studies
  • Male
  • Smoking Cessation/methods
  • Time Factors
  • Tobacco Use Cessation Devices/adverse effects
  • Tobacco Use Disorder/epidemiology
  • United States/epidemiology
  • Vaping/adverse effects
  • Young Adult


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