HealthDay News — Electronic nicotine delivery systems (ENDS) are associated with an increased risk for cigarette smoking relapse, while adults who vape nontobacco flavored electronic cigarettes are more likely to quit smoking, according to two studies published online June 5 in JAMA Network Open.

Colm D. Everard, Ph.D., from the National Institutes of Health in Bethesda, Maryland, and colleagues examined data from the Population Assessment of Tobacco and Health Study waves 1 to 4 (2013 to 2018) to examine the association between ENDS use and cigarette smoking relapse among 2,273 former cigarette smokers. The researchers found that ENDS use was associated with a significant risk for smoking relapse among former smokers and long-term former smokers (adjusted hazard ratios, 1.63 and 3.79, respectively).

Abigail S. Friedman, Ph.D., and SiQinq Xu, from the Yale School of Public Health in New Haven, Connecticut, and colleagues examined whether new uptake of flavored cigarettes is more strongly associated with subsequent smoking initiation and cessation than uptake of unflavored cigarettes among youth, young adults, and prime-age adults (ages 12 to 17, 18 to 24, and 25 to 54 years, respectively). The researchers found that vaping uptake was positively associated with smoking uptake in youth and in emerging adults (adjusted odds ratios, 6.75 and 3.20, respectively). In adults, vaping uptake was associated with cessation (adjusted odds ratio, 1.34). Vaping nontobacco flavors was associated with increased smoking cessation among adults compared with vaping tobacco flavors (adjusted odds ratio, 2.28).

“These studies add to other evidence suggesting that e-cigarettes will not be the final answer to the smoking pandemic that has taken so many lives and that remains a major threat to public health,” write the authors of an accompanying editorial.


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One author from the Everard study disclosed financial ties to the pharmaceutical and other industries.

Abstract/Full Text – Everard

Abstract/Full Text – Friedman and Xu

Editorial