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Association of electronic cigarette use with smoking habits, demographic factors, and respiratory symptoms

Linnea Hedman, Helena Backman, Caroline Stridsman, et al.
JAMA Network Open 2018;1:e180789

Although electronic cigarettes (e-cigarettes) are becoming an increasingly popular smoking cessation aid, data regarding their long-term impact on health and role in smoking cessation are lacking.

In this randomised, cross-sectional study, researchers explored e-cigarette use in Sweden and associated smoking habits to understand what role they play in smoking cessation. They conducted postal questionnaire surveys in random population samples across North and West Sweden.

Of the 30,272 respondents, 12.3% were classified as current smokers, 24.4% were former smokers (i.e. stopped smoking for >1 year), 63.3% were classified as never smokers and 2.0% were identified as e-cigarette users. Dual users were the most common, with 9.8% of current smokers being classified as e-cigarette users, compared to only 1.1% of former smokers and 0.6% of never smokers.

This high prevalence of dual use suggested that e-cigarettes in Sweden were not currently encouraging smoking cessation. However, it is important to note that former smokers were only classified as such if they had stopped smoking for >1 year. As a result, some patients may have been misclassified as current smokers, potentially impacting the number of dual users recorded in this study. More research is therefore required to understand the role of e-cigarettes as smoking cessation aids before further conclusions are made.

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