Cigarette smoking relapse among recent former smokers who switched to e-cigarettes or other tobacco products

Electronic cigarettes (or e-cigarettes) have been studied as a cessation tool in clinical trials and longitudinal studies. Less well-studied is how e-cigarette use among former smokers affects smoking relapse, a concept that is not well-defined. A recent paper looked at this issue but only used any cigarette smoking in the past 12 months as their smoking relapse measure. We examine how the use of different definitions of relapse might affect findings.

Using longitudinal data from three consecutive waves (waves 1-3 and 2-4) of the Population Assessment of Tobacco and Health (PATH) Study, we found that more than half of recent former smokers relapsed if we define relapse as any cigarette smoking in the past 12 months (Measure I), 40.3% relapsed if we use the definition of any past 30-day smoking (Measure II), and 30.1% relapsed if we use the definition of smoking on >=3 days in the past 30 days (Measure III). Compared with those who remained tobacco-free, recent former smokers who switched to current e-cigarette use or any non-cigarette tobacco use were marginally more likely to relapse using Measure I but showed no increased likelihood of relapse using measures II or III. Recent former smokers who switched to current e-cigarette use may be more likely to slip but reported no difference in the likelihood of cigarette smoking relapse, especially when not defining relapse as any lapse during the 12 months following quitting.