New Study Provides Evidence that Switching to E-Cigarettes Can Enhance Smoking Cessation, Even for Dual Users

Electronic cigarette opponents have long argued that dual use offers no health benefits to smokers. Dual use refers to the use of both e-cigarettes and tobacco cigarettes. While clinical trials show that a small proportion of electronic cigarette users are able to quit completely, a quite large proportion of these smokers are able to substantially reduce their cigarette consumption. Anti-smoking advocates have widely argued that this reduction in consumption offers no health benefits. I have already debunked that myth by showing that substantial reductions in cigarette consumption can produce dramatic improvements in respiratory health, especially among smokers with asthma or other forms of obstructive lung disease.

Today, I present new evidence that beyond the direct respiratory health improvement, switching to e-cigarettes, even partially (i.e., dual use), can significantly enhance the prospects of a smoker quitting completely.

The Rest of the Story

A study published online ahead of print this month in the journal Nicotine & Tobacco Research demonstrates that smokers who are able to reduce the number of cigarettes smoked per day are more likely to eventually quit smoking.

The authors report the major findings as follows: "The intervention trials that reported effect sizes found that every one percent decrease in CPD or carbon monoxide (CO) was associated with a 3% to 4% increase in the odds of cessation. The naturalistic studies found that ordinal (e.g., quartile) increases in participants’ magnitude of reduction in CPD were associated with 50% to 290% increases in the odds of cessation."

By these numbers, if an electronic cigarette user (a dual user) cut down her cigarette intake by 80% - which is not uncommon among smokers who use e-cigarettes - her odds of quitting could increase by as much as 320%.

Of course, in these studies nicotine replacement therapy was used to achieve the initial reduction in cigarette consumption. However, there is no reason to believe that a dramatic reduction in cigarette consumption achieved through the use of electronic cigarettes would not also increase the odds of eventual cessation.

All in all, these results suggest that rather than being a bad result of e-cigarette trial, dual use may instead be a bridge to eventual smoking cessation.

This is important because it means that anti-smoking groups which are encouraging dual users to return to smoking by telling them it is no better than smoking exclusively are harming the health of the public, both directly and in terms of impeding smoking cessation.