Associations between e-cigarette use and e-cigarette flavors with cigarette smoking quit attempts and quit success: Evidence from a US large, nationally representative 2018-2019 survey

Objectives While many studies have examined the association between e-cigarette use and smoking cessation, fewer have considered the impact of e-cigarette flavors on cessation outcomes.

This study extends previous studies by examining the effects of e-cigarette use and e-cigarette flavors on smoking quit attempts and quit success.

Methods We used data from the 2018-2019 Tobacco Use Supplement-Current Population Survey (TUS-CPS) survey. Multivariate logistic regression analyses were used to investigate the associations between e-cigarette and flavor use with quit attempts among individuals who smoked 12 months ago and quit success. Two current e-cigarette use definitions were considered; currently use every day or some days vs. 20+ days in the past 30-days.

Results Compared to those not using e-cigarettes, current everyday or someday e-cigarette use with all non-tobacco flavors had an adjusted odds ratio (AOR) of 2.9 (95% CI: 2.4-3.5) for quit attempts and 1.7 (95% CI: 1.3-2.2) for quit success. 20+ days e-cigarette use with flavors had stronger associations with quit attempts (AOR=4.2, 95% CI: 3.1-5.5) and quit success (AOR=4.0, 95% CI: 2.9-5.4). E-cigarette users with non-tobacco flavors were more likely to succeed in quitting compared to those exclusively using non-flavored or tobacco-flavored e-cigarettes. Menthol/mint flavor users had slightly higher odds of quit attempts and success than users of other non-tobacco flavors.

Conclusions E-cigarette use is positively associated with both making a smoking quit attempt and quit success. Those using flavored e-cigarettes, particularly menthol/mint, are more likely to quit successfully.

Implications E-cigarette use is positively associated with both making a quit attempt and quit success, and those using flavored e-cigarettes are more likely to successfully quit smoking, with no statistically significant differences between use of menthol or mint flavored e-cigarettes versus use of other non-tobacco flavored products. This suggests that the potential for e-cigarettes to help people who currently smoke quit could be maintained with the availability of menthol or mint flavored e-cigarettes, even if other non-tobacco flavored products, which are associated with e-cigarette use among youth, were removed from the market.