Study links vape use to higher smoking quit rates among adults

A major new US study has found that e-cigarette use is increasingly associated with higher smoking cessation rates among adults, as vaping becomes more embedded in population-level tobacco use patterns.

The research, published in Frontiers in Public Health, analysed longitudinal data from the nationally representative Population Assessment of Tobacco and Health (PATH) Study, tracking behaviour across two periods: 2014–2017 and 2019–2022.

The findings show a marked increase in quitting among adult smokers who use e-cigarettes, particularly frequent users. In the 2019–2022 period, 42.4 per cent of adults who both smoked and used e-cigarettes frequently had quit smoking by 2022, compared with 20 per cent in the 2014–2017 period.

Overall, around 1.6 million adults who smoked cigarettes in 2019 and used e-cigarettes frequently had stopped smoking by 2022, underlining the growing role of vaping as a potential smoking cessation pathway.

Researchers suggest that changes in the vaping market, including the rise of nicotine salt-based products, may help explain these trends. These products enable higher nicotine delivery with less irritation, potentially improving their effectiveness as a substitute for combustible cigarettes.

The study also found that even less frequent e-cigarette use was linked to improved quit outcomes over time. Around 35 per cent of adults who smoked and used e-cigarettes less frequently had quit smoking within three years, compared with 24 per cent of those who did not use e-cigarettes at all.

The findings also showed a sharp increase in sustained and frequent e-cigarette use among young people in the later period. Among youth who were already frequent users, more than half (51 per cent) continued frequent use between 2019 and 2022, compared with just 13 per cent in the earlier 2014–2017 period.

At the same time, progression to frequent vaping also rose, with 35 per cent of less frequent youth users moving to more regular use in the later period, up from 23 per cent previously.

However, the study also found that overall uptake among youth may be stabilising or declining. Around 17 per cent of young people who had never used e-cigarettes in 2019 went on to try them by 2022, compared with 27 per cent in the earlier period, suggesting reduced initiation rates.

Alongside these findings, the research highlights broader shifts in vaping and smoking behaviours across the population. While uptake patterns and usage trajectories have evolved in recent years, the authors emphasise that e-cigarettes appear to be playing a more significant role in smoking cessation than in earlier years.

The study points to a combination of factors influencing these trends, including product innovation, regulatory changes, and wider societal shifts such as the COVID-19 pandemic.

However, the authors caution that the findings are observational and should be interpreted as descriptive rather than establishing causation. They argue that the results nonetheless provide valuable context for policymakers assessing the public health impact of e-cigarettes.

In the US, regulators apply a population-level framework that weighs potential benefits, such as increased smoking cessation, against potential harms when making decisions about tobacco and nicotine products.