Recently updated data from the Smoking Toolkit Study demonstrate that there has been a striking increase in the rate of quit attempts in England during the past two years, and that this increase is associated with a dramatic rise in the use of electronic cigarettes. These data suggest that the proliferation of electronic cigarettes in England is the reason for the marked increase in smoking cessation attempts.
The proportion of cigarette smokers using electronic cigarettes rose dramatically in England from 2% in May 2011 to 16% in August 2013. Associated with this proliferation of electronic cigarettes was:
(1) an increase in the percentage of smokers making quit attempts; and
(2) an increase in the percentage of smokers who reported being motivated to quit smoking (i.e., intending to stop smoking soon).
While these quit attempts do not appear to have yet resulted in a demonstrable decline in the prevalence of cigarette smoking, one would expect to observe such a decline with sustained follow-up, as increased quit attempts and increased motivation to quit are known to be associated with rates of successful cessation.
While these data do not prove that the use of electronic cigarettes is what caused the increase in quit attempts, the dramatic nature of the increase in both phenomena and the timing of these changes strongly suggests that what we are observing is an effect of electronic cigarette use.
The Rest of the Story
These data suggest another potential advantage of electronic cigarettes: it is possible that they stimulate quit attempts. Independent of their potential effectiveness in helping smokers quit, if these products lead to an increased proportion of smokers trying to quit, they would be expected to have a positive public health impact.
These data add to the existing evidence which suggests that electronic cigarettes are having significant public health benefits by stimulating and facilitating smoking cessation. While they are no wonder drug, they appear to be at least as effective as nicotine replacement products and to offer hope to millions of smokers who have been unsuccessful using the FDA-approved smoking cessation products.
Surprisingly, anti-smoking researchers and groups continue to advocate against electronic cigarettes and refuse to acknowledge the overwhelming evidence that these products are indeed helping thousands of smokers to stay off cigarettes.
The two potential drawbacks of electronic cigarettes - that they could inhibit complete nicotine cessation in smokers who would otherwise have achieved that and that they will be a gateway to smoking among youth - do not appear to be of concern at the present time. There is no evidence that either phenomenon is occurring. Most electronic cigarette users are trying these products specifically because they have failed with other approaches. So these are not smokers who would miraculously quit completely if only electronic cigarettes were not available. Neither is there any evidence that these products are starter products for youth who then go on to initiate smoking.
Thus, at the present time, it appears that electronic cigarettes are having a substantial net positive effect on the public's health. Yet anti-smoking groups continue to discourage this approach. Fortunately, there is a limit to how long these groups can continue to deny the overwhelming evidence.