Use of Tobacco Cessation Aids and Likelihood of Smoking Cessation: A French Population-based Study

Although smoking prevalence has been decreasing worldwide, sustained tobacco cessation remains a challenging goal for many smokers. Several types of tobacco cessation aids are available such as nicotine replacement therapy (NRT) and electronic cigarette, the effectiveness of the latter is still a matter of debate. This study aims to test differences in successful smoking cessation according to the type of aid used, considering selection and confounding factors. We used data from the 2017 French Health Barometer, a cross-sectional survey conducted by France's Public Health Agency. We studied the relationship between e-cigarette and NRT use and three distinct outcomes collected retrospectively: smoking status 6, 12 and 24 months after the cessation attempt (yes vs no). All results were weighted to be nationally-representative and controlled for propensity scores included via overlap weighting (OW). The use of an e-cigarette was significantly associated with tobacco cessation at 6 months (OWeighted OR = 1.38, 95 % CI: 1.03-1.99) as well as at 12 months (OWeighted OR = 1.61, 95 % CI: 1.13-2.27) and 24 months (OWeighted OR = 1.61, 95 % CI: 1.01-2.57). The use of NRT was negatively associated with tobacco cessation at 12 months (OWeighted OR = 0.62, 95 % CI: 0.43-0.89) and 24 months (OWeighted OR = 0.57, 95 % CI: 0.35-0.92). While the use of an e-cigarette alone or combined with NRT is associated with an increase in the likelihood of smoking cessation, the effects of the use of NRT alone on long-term smoking abstinence are probably limited.