E-cigarette use is strongly associated with recent smoking cessation: an analysis of a representative population sample in Greece

Abstract

The purpose was to examine the association between e-cigarette use and smoking cessation according to quit duration in Greece in 2017. A cross-sectional survey of a representative sample of adults living in Attica prefecture was performed in May 2017 through telephone interviews. The present analysis was confined to current and former smokers (n = 2568). Logistic regression analyses were performed with current and current daily e-cigarette use being the dependent variables and demographics and smoking status (current smokers vs smoking cessation for ≤ 12 months, 13–36 months, 36–72 months, and > 72 months) being independent variables. Almost half of former smokers (47.7%) had quit smoking for ≤ 72 months. Current e-cigarette use was more prevalent among former smokers of ≤ 12 months (26.2%) and 13–36 months (27.0%), and was rare among former smokers of > 72 months (1.0%). Current e-cigarette use was strongly associated with smoking cessation for ≤ 12 months (OR 6.12, 95% CI 4.11–9.10, P < 0.001) and 13–36 months (OR 6.28, 95% CI 4.25–9.28, P < 0.001). Current daily e-cigarette use was also strongly associated with smoking cessation for ≤ 12 months (OR 10.41, 95% CI 6.56–16.53, P < 0.001) and 13–36 months (OR 11.18, 95% CI 7.12–17.55, P < 0.001). Current and current daily e-cigarette use were not significantly associated with smoking cessation for 37–72 months, and were negatively associated with smoking cessation for > 72 months. Current and current daily e-cigarette use are strongly associated with recent smoking cessation in Greece, suggesting a positive public health impact in a country with the highest prevalence of smoking in the European Union. E-cigarettes do not appear to promote relapse in long term former smokers. Duration of smoking cessation and frequency of e-cigarette use should be taken into consideration when examining the association between e-cigarette use and smoking cessation in population studies.

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Correspondence to Konstantinos Farsalinos.

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Authors report no conflicts of interest for the past 36 months.

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This study was approved by the ethics committee of the Onassis Cardiac Surgery Center (reference nr: 591/14.12.16).

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All participants provided verbal informed consent at the beginning of the telephone interview before participating to the study.

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This article is part of the Topical Collection: Health Impact of Electronic Cigarettes and Tobacco Heating Systems.

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Farsalinos, K., Siakas, G., Poulas, K. et al. E-cigarette use is strongly associated with recent smoking cessation: an analysis of a representative population sample in Greece. Intern Emerg Med 14, 835–842 (2019). https://doi.org/10.1007/s11739-018-02023-x

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Keywords

  • Electronic cigarettes
  • Smoking
  • Smoking cessation
  • Nicotine
  • Greece