Trends in the use of vaping products and other smoking cessation methods among adults who attempt to stop smoking: Findings from ITC Four Country Smoking and Vaping Surveys (2016-2020).

Abstract

Introduction: E-cigarettes are an increasingly popular method of smoking cessation assistance; however, there is little research on whether this has affected the number of smokers who quit using "any" evidence-based cessation aid. This study examined trends in the use of cessation aids, including e-cigarettes and other evidence-based methods.

Methods: Data are cross-sectional surveys in 2016, 2018, and 2020 from the ITC Four Country Smoking and Vaping Survey conducted in Canada, United States (US), England, and Australia. Respondents were adults (≥18) recruited by commercial panel firms who currently smoked, and/or quit smoking in the past 12-months. Respondents were asked about use of e-cigarettes, nicotine replacement therapies (NRT), prescription medications, quitlines, and counseling services during their last quit attempt (LQA). GEE regression models analyzed separately by country examined use of cessation assistance among 14 536 observations (Canada = 4880; US = 2917; England = 4846; Australia = 1898).

Results: E-cigarettes (29.9%) and NRT (29.8%) were popular methods of cessation assistance at LQA. Using e-cigarettes at LQA increased in Australia (2016 = 11.1%; 2020 = 25.1%; p=.002) and England (2016 = 37.1%; 2018 = 46.7%; p=.002), with no significant change in Canada or the US. Across all countries, there was little change over time in the overall use of evidence-based cessation assistance. Nearly half of respondents used some form of cessation assistance excluding e-cigarettes. Approximately two-thirds used "any" form of evidence-based cessation including e-cigarettes at LQA, which decreased in Canada (2016 = 64.0%, 2020 = 58.9%; p=.010).

Conclusion: While e-cigarettes are a popular cessation aid, use of other evidence-based cessation assistance has remained comparatively stable among adults that tried to quit smoking.

Implications: The findings indicated that e-cigarettes are a popular cessation method among adults trying to quit smoking. Despite differences in e-cigarette use and regulatory environments in the four countries, rates of evidence-based cessation assistance were similar across countries and over time. E-cigarettes can be an effective method for stopping smoking; however, the current study suggests few, if any, changes in the proportion of adults who smoke using any evidence-based form of cessation assistance, despite changes in the use of e-cigarettes as a quit aid.