Smokers with no intention of quitting regular cigarettes are 8 times more likely to kick the habit after using e-cigarettes, according to a study published in JAMA Network Open. Although e-cigarettes are also harmful, it’s a step in the right direction. The researchers support the theory that taking even 1 step toward quitting smoking can have a positive impact on “net cigarette cessation.”

To explore how well e-cigarettes worked in individuals with no intention of quitting smoking, the researchers used data from 4 waves of the longitudinal Population Assessment of Tobacco and Health (PATH) Study (waves 2-5). The study collects self-reported data on tobacco use and related behaviors. The researchers surveyed 1,600 adults from the study who were aged 18 or older, smoked daily, were not using e-cigarettes, and had no plans to quit smoking.

Among the study population, there was a total of 6.2% adult daily cigarette smokers who were not using e-cigarettes and had no plans to ever quit regular cigarettes, and were not smoking regular cigarettes at all at follow-up (95% CI, 5.0%-7.5%). The odds of quitting were higher among the daily e-cigarette users (28.0%; 95% CI, 15.2%-45.9%) compared with those who either did not use e-cigarettes at all (5.8%; 95% CI, 4.6-7.2; aOR, 8.11; 95% CI, 3.14-20.97) or who used them inconsistently.

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While the researchers state their data align with previous studies on e-cigarette use and smoking cessation, they also note natural history data show “intentions to quit smoking can change quickly and repeatedly and may not be a good indicator of behavior.”

The researchers note their inability to evaluate whether intentions to quit changed after starting e-cigarettes is a limitation of the study. They also note the possibility of self-selection differences among those who did and did not subsequently use e-cigarettes. The researchers did not investigate relapse.

“Although controlled experimental studies have shown associations between e-cigarette use and smoking cessation among smokers without plans to quit, it is important to identify whether similar associations exist in a real-world context,” the researchers conclude.

“This cohort study found an association between daily e-cigarette use and cigarette discontinuation among daily smokers in the US population who initially had no plans to ever quit smoking in their lifetimes. These findings call for consideration of smokers who are not planning to quit when evaluating the risk-benefit potential of e-cigarettes for smoking cessation in the population.”


Kasza KA, Edwards KC, Kimmel HL, et al. Association of e-cigarette use with discontinuation of cigarette smoking among adult smokers who were initially never planning to quit. JAMA Netw Open. 2021;4(12):e2140880. doi:10.1001/jamanetworkopen.2021.40880