New PATH Study findings underscore importance of sufficient nicotine replacement for smoking cessation

  • Study evaluated flavors, types of devices, frequency of use
  • Newer e-cigarettes likely deliver higher levels of nicotine
  • Paper published today in JAMA Network Open

BUFFALO, N.Y. — Adults in the U.S. who used e-cigarettes daily and also smoked combustible cigarettes were more likely to quit smoking than those who smoked but used e-cigarettes less frequently, according to a study led by experts at Roswell Park Comprehensive Cancer Center. The research, published today in the journal JAMA Network Open, suggests that daily e-cigarette use may help some people quit using combustible cigarettes.

The new work documents a collaborative effort by investigators from Roswell Park, the University of Waterloo School of Public Health Sciences in Ontario, Canada, and the Medical University of South Carolina.

“Our study shows that adults who smoke cigarettes and use newer e-cigarettes have higher cigarette quit rates than those who used e-cigarettes in the past,” says Karin Kasza, PhD, Assistant Professor of Oncology in Roswell Park’s Department of Health Behavior and first author of the paper. “Our findings are consistent with earlier evidence that sufficient nicotine replacement can be helpful for quitting smoking. Recent guidance from the Center for Tobacco Products indicates the importance of switching completely away from combustible cigarettes for those who are also using e-cigarettes.”

The research team analyzed data collected for the Population Assessment of Tobacco and Health (PATH) Study, a National Institutes of Health/Food and Drug Administration study scientifically led since 2013 by Andrew Hyland, PhD, Chair of Health Behavior at Roswell Park. The scientists tracked 1,985 adults in the U.S. to determine whether characteristics of e-cigarettes are associated with the likelihood of smoking cessation, examining not only frequency of use but also flavor type and type of device.

The team reviewed data from the period 2014-2021, a time during which available options of e-cigarettes changed. Their analysis reveals that daily vs. nondaily use of e-cigarettes is linked to higher overall rates of quitting combustible cigarettes (12.8% vs. 6.1%). Adults who used e-cigarettes in 2019 were more likely than those who used them in 2014-15 to stop smoking traditional cigarettes (12.0% vs. 5.3%). There was limited evidence for flavor or device type being associated with cigarette cessation.

Other studies show that newer e-cigarettes deliver higher doses of nicotine more efficiently, which could be a reason why these findings were observed. The authors acknowledge that more frequent use of e-cigarettes may also reflect greater determination to quit smoking combustible cigarettes and that their study did not evaluate risks of youth e-cigarette use.

“Since there is no safe tobacco product, eventual abstinence from all tobacco products is the end goal,” says Dr. Hyland, who is senior author on the new work.

The paper was funded by the National Institute on Drug Abuse of the National Institutes of Health and FDA Center for Tobacco Products (project number R21DA051446).