New versus continued e-cigarette use and cigarette reuptake among US adults who formerly smoked cigarettes

E-cigarette use has been associated with cigarette reuptake after a period of abstinence from cigarette smoking. This study examined how e-cigarette patterns across time (e.g., new versus continued use) contribute to cigarette reuptake among U.S. adults.

Adults (N = 4,511) declaring former cigarette smoking at Wave (W) 6 (2021) of the Population Assessment of Tobacco and Health Study were included. Multivariable logistic regressions examined associations between W6 past 30-day (P30D) e-cigarette use, W7 (2022-2023) P30D e-cigarette use, and W7 P30D cigarette reuptake, as well as the interaction between W6 and W7 P30D e-cigarette use on W7 P30D cigarette reuptake.

Among adults with former cigarette smoking at W6, 11.4% had P30D cigarette reuptake at W7. P30D cigarette reuptake was lowest among those who did not use e-cigarettes at both waves (4.9%) compared to respondents with e-cigarette use at one or both waves (range 16.4-34.5%). Adults with new e-cigarette use at W7 (i.e., no W6 e-cigarette use) had higher odds of P30D cigarette reuptake (AOR = 3.68; 95% CI = 2.34, 5.79) compared to those with no e-cigarette use at either wave. No significant difference was found between adults with e-cigarette use at both waves and no e-cigarette use at either wave on P30D cigarette reuptake.

P30D cigarette reuptake was lowest among those who did not use e-cigarettes at all. Initiating e-cigarette use was associated with P30D cigarette reuptake whereas continued e-cigarette use over 1-2 years was not. Relapse prevention programs for those who have quit smoking may be enhanced by research that builds on these findings.