Association between electronic cigarette use and smoking cessation in the European Union in 2017: analysis of a representative sample of 13 057 Europeans from 28 countries (2021)

OBJECTIVES: To examine the association between electronic cigarette (e-cigarette) use and smoking cessation in the European Union (EU) in 2017 according to e-cigarette use frequency and smoking cessation duration.
DESIGN: Cross-sectional survey of EU citizens, representative of the population (Special Eurobarometer 458). Weighted proportions (95% CI) and adjusted prevalence ratios (aPRs) were calculated.
SETTING: EU.
PARTICIPANTS: 13 057 EU citizens aged >=15 years (6904 current and 6153 former smokers).
RESULTS: Current daily e-cigarette use was reported by 2.4% (1.8%-3.1%) of current and 3.3% (2.5%-4.2%) of former smokers (p=0.002), while former daily use was reported by 5.6% (4.7%-6.8%) and 1.9% (1.3%-2.7%), respectively (p<0.001). More than half of all former smokers had quit for >10 years. Current daily e-cigarette use was rare among former smokers of >10 years (0.2%, 0.1%-0.6%) and was more prevalent in former smokers of <=2 and 3-5 years (12.9%, 9.1%-17.9% and 9.0%, 5.8%-13.7%, respectively). Compared with never use, current daily e-cigarette use was associated with being a former smoker of <=2 (aPR 4.96, 95% CI 3.57 to 6.90) and 3-5 years (aPR 3.20, 95% CI 2.10 to 4.87). Former daily e-cigarette use was associated with being a former smoker of <=2 years (aPR 1.96, 95% CI 1.21 to 3.12). Current daily e-cigarette use was negatively associated with being a former smoker of 5-10 and >10 years.
CONCLUSIONS: Current daily e-cigarette use in the EU in 2017 was rare among former smokers of >10 years and was positively associated with recent (<=5 years) smoking cessation. Former daily e-cigarette use was also positively associated with recent (<=2 years) smoking cessation.