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Committed adult smokers who start vaping more likely to drop cigarettes

Smokers who don’t plan to quit tend to be the heaviest smokers

e-cigarettes Illustration by Alex Castro / The Verge

Adult smokers who say that they don’t plan to quit smoking but who start using e-cigarettes are more likely quit than those who don’t start vaping, according to a new study. People who say they’re not trying to quit often aren’t included in studies of the potential benefits of e-cigarettes for adult smokers, and the new data shows that the group should be considered during that type of analysis.

In the new study, published Tuesday in JAMA Network Open, researchers evaluated data from the Population Assessment of Tobacco and Health (PATH) Study, which is run by the National Institutes of Health (NIH) and the Food and Drug Administration (FDA). Participants were interviewed about their tobacco use four times between 2014 and 2019.

Of the study group, 1,600 people said in initial interviews that they didn’t use e-cigarettes and didn’t plan to ever quit smoking cigarettes. By the next set of interviews, around 6 percent of that group had stopped smoking traditional cigarettes. Participants who’d started using e-cigarettes daily during that time were much more likely to be in that 6 percent than participants who hadn’t — 28 percent of the group using e-cigarettes had stopped smoking cigarettes, compared to just under 6 percent of the group not using e-cigarettes.

The relationship might be because smokers who start using e-cigarettes tend to shift toward planning to quit smoking, the authors suggest, a pattern seen in previous research from the PATH Study and in other experiments. The new analysis didn’t untangle whether people’s decisions to quit came after they started smoking e-cigarettes, so it can’t pinpoint the cause of the change. The switch, though, is likely beneficial — some research shows e-cigarettes are less harmful than traditional cigarettes, even if they’re not harmless.

The study was released while the FDA is still reviewing some e-cigarette related products, including those made by Juul. The agency has blown past its September deadline to evaluate applications from e-cigarette companies — after a yearlong period without enforcement, companies now need authorization before they can market their products. The only e-cigarettes the FDA has authorized so far are tobacco-flavored e-cigarettes from the RJ Reynolds Vapor Company. At the end of December, it had rejected 260 applications.

The FDA says its focus is on figuring out whether a vaping or e-cigarette product has benefits to adult smokers that outweigh the risks to kids and teenagers, who started vaping in huge numbers in 2018 and tend to be attracted to flavored products. The new research indicates that smokers who say they don’t plan to quit should be included in those risk-benefit calculations, the study authors note.