Vaping after stopping smoking linked to lower risk of relapse back to smoking 

Embargo: Immediate  Smokers who quit with the help of e-cigarettes often continue vaping, but it is not known whether this promotes or prevents relapse back to smoking.

Led by Queen Mary University of London’s Professor Peter Hajek, this study in the journal Addiction, “Continuing use of e-cigarettes after stopping smoking and relapse: Secondary analysis of a large randomised control trial”  provides the first evidence that smokers who successfully stop smoking with the help of vapes and continue to use them may be reducing their risk of relapse.  

Only a relatively small proportion of smokers who quit with the help of nicotine replacement therapies (NRT) such as nicotine chewing gum and patches continue to use NRT.  In contrast, smokers who quit with the help of e-cigarettes (EC) are much more likely to continue using vapes. This raises an important question of whether continuing use of vapes increases the risk of relapse back to smoking, in which case smokers should be advised against such use; or whether it provides a protection from relapse, in which case it would have a positive effect.   

The team conducted a secondary analysis of their landmark randomised controlled trial that included 886 smokers and showed that EC are more effective in helping smokers quit than NRT. In this report, they compared relapse rates in the two study arms, and in abstainers who did, and did not use e-cigarettes. Relapse was calculated for the time periods between 4 weeks and 1 year, and between 6 months and 1year. 

Over both time periods, abstainers in the EC arm were less likely to relapse than abstainers in the NRT arm; and abstainers who used EC were less likely to relapse than abstainers who did not vape.   

Professor Peter Hajek, Director of the Health and Lifestyle Research Unit at Queen Mary University of London, said: “EC use carries only a small fraction of risks of smoking. Among people who quit smoking with the help of vapes, on-going vaping prevents relapse. It would have a positive health impact and should not be discouraged’”  

Hayden McRobbie Professor of Population Health at Queen Mary University of London said: "A big question in helping people stay smokefree is how best to prevent relapse. For people who have quit smoking using EC, carrying on vaping for as long as they need to feel confident they won’t slip back to smoking is likely to be beneficial." 

Dr Francesca Pesola, Senior Lecturer in Statistics at Queen Mary University of London said “We now want further studies to see whether this finding holds over a longer period of time.” 

The authors on this paper were academics from Queen Mary University of London (Peter Hajek, Dunja Przulj, Katie Myers Smith, Peter Sasieni, Hayden McRobbie) Francesca Pesola, University of York (Jinshuo Li) the National Centre for smoking Cessation and Training in Leicester (Louise Ross), the National Drug and Alcohol Research Centre, University of New South Wales (Hayden McRobbie), and Roswell Park Comprehensive Cancer Center (Maciej Goniewicz). 

ENDS   

NOTES TO EDITORS   

Paper details:    

"Continuing use of e-cigarettes after stopping smoking and relapse: Secondary analysis of a large randomised control trial", in  Addiction by Peter Hajek et al. 

DOI: 10.1111/add.70294 

A copy of the paper is available upon request.   

Conflict of interest:  

Louise Ross received a speaker fee in 2024 from Consilient Health. 

Funded by:    

This trial was funded by the National Institute for Health Research and by Cancer Research UK. F.P was supported by the Barts Hospital Charity. 

About Queen Mary University of London     

www.qmul.ac.uk       

At Queen Mary University of London, we believe that a diversity of ideas helps us achieve the previously unthinkable.    

Throughout our history, we’ve fostered social justice and improved lives through academic excellence. And we continue to live and breathe this spirit today, not because it’s simply ‘the right thing to do’ but for what it helps us achieve and the intellectual brilliance it delivers.      

Our reformer heritage informs our conviction that great ideas can and should come from anywhere. It’s an approach that has brought results across the globe, from the communities of east London to the favelas of Rio de Janeiro.      

We continue to embrace diversity of thought and opinion in everything we do, in the belief that when views collide, disciplines interact, and perspectives intersect, truly original thought takes form.