Is Prevalence of E-Cigarette and Nicotine Replacement Therapy Use among Smokers Associated with Average Cigarette Consumption in England?

Abstract

Objectives: Many smokers use e-cigarettes and licensed nicotine replacement therapy (NRT), often in an attempt to reduce their cigarette consumption. We estimated how far changes in prevalence of e-cigarette and NRT use while smoking were accompanied by changes in cigarette consumption at the population level.

Design: Repeated representative cross-sectional population surveys of adults aged 16+ years in England.

Methods: We used Autoregressive Integrated Moving Average with Exogeneous Input (ARIMAX) modelling of monthly data between 2006 and 2016 from the Smoking Toolkit Study. Prevalence of e-cigarette use and NRT use in current smokers, and specifically for smoking reduction and temporary abstinence , were input variables. Mean daily cigarette consumption was the dependent variable. Analyses involved adjustment for mass media expenditure and tobacco-control policies.

Results: No statistically significant associations were found between changes in use of e-cigarettes (β −0.012, 95% CI −0.026 to 0.002) or NRT (β 0.015, 95% CI −0.026 to 0.055) while smoking and daily cigarette consumption. Neither did we find clear evidence for an association between e-cigarette use (β −0.010, 95% CI −0.025 to 0.005 and β 0.011, 95%–0.027 to 0.004) or NRT use (β 0.006, 95%–0.030 to 0.043 and β 0.022, 95%–0.020 to 0.063) specifically for smoking reduction and temporary abstinence, respectively, and changes in daily cigarette consumption.

Conclusion: If use of e-cigarettes and licensed NRT while smoking acted to reduce cigarette consumption in England between 2006 and 2016, the effect was likely very small at a population level.