E-cigarette use and change in plans to quit cigarette smoking among adult smokers in the United States: Longitudinal findings from the PATH Study 2014–2019

Karin A. Kasza, Kathryn C. Edwards, Andrew Anesetti-Rothermel, Me Lisa R. Creamer, K. Michael Cummings, Raymond S. Niaura, Akshika Sharma, Stephanie R. Pitts, Sara K. Head, Colm D. Everard, Dorothy K. Hatsukami, Andrew Hyland

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Introduction: Much of the population-based e-cigarette use and cigarette cessation literature is restricted to smokers who have expressed intention to quit smoking, though experimental studies suggest e-cigarette use might motivate some smokers to change their quit intentions. We used U.S. nationally representative data to evaluate whether e-cigarette use by smokers initially not planning to ever quit is associated with change in plans to quit. Methods: Longitudinal Population Assessment of Tobacco and Health (PATH) Study data collected between 2014 and 2019 were analyzed. Main analyses were conducted among adult daily cigarette smokers not currently using e-cigarettes with no plans to ever quit smoking (n = 2366 observations from n = 1532 individuals). Generalized estimating equations were used to evaluate the association between change in e-cigarette use and change in plans to quit smoking within the next six months, over three assessment pairs. Results: Daily cigarette smokers with no plans to quit had a higher rate of change to plan to quit if at follow-up they used e-cigarettes daily (41.4%, 95% CI: 27.1–57.3%) versus not at all (12.4%, 95% CI: 10.6–14.5%; aOR = 5.7, 95% CI: 2.9–11.2). Rate of change to plan to quit did not statistically differ between those who at follow-up used e-cigarettes some days versus not at all. Conclusions: Among adult daily cigarette smokers initially not planning to ever quit, subsequent daily e-cigarette use is associated with subsequent plans to quit smoking. Population-level research on e-cigarette use that is focused on smokers already motivated to quit may limit a complete evaluation of the smoker population.

Original languageEnglish (US)
Article number107124
JournalAddictive Behaviors
StatePublished - Jan 2022

Bibliographical note

Funding Information:
This manuscript is supported with Federal funds from the National Institute on Drug Abuse, National Institutes of Health, and the Center for Tobacco Products, Food and Drug Administration (FDA), Department of Health and Human Services, under contracts to Westat (Contract Nos. HHSN271201100027C and HHSN271201600001C).

Funding Information:
K. Michael Cummings provides expert testimony on the health effects of smoking and tobacco industry tactics in lawsuits filed against the tobacco industry. He has also received payment as a consultant to Pfizer, Inc., for services on an external advisory panel to assess ways to improve smoking cessation delivery in health care settings. Raymond Niaura has served as a paid consultant to the Government of Canada via a contract with Industrial Economics Inc., has received an honorarium for a virtual meeting from Pfizer Inc. within the past 3 years, and was an unpaid grant reviewer for the Foundation for a Smoke Free World.

Publisher Copyright:
© 2021 Elsevier Ltd


  • Daily smokers
  • E-cigarette use
  • Intention to quit
  • Longitudinal
  • Population


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