Last week the United States Centers for Disease Control and Prevention (CDC) announced that the number of adult smokers over age 18 declined during 2010 by 1.3 million smokers, reducing the prevalence to 19.3%. This reduction ended a rise from 44.5 adult smokers in 2004 to 46.6 million in 2009. What was going on during 2010 that made a difference?
In the American Journal of Preventative Medicine, Ayers, et al. reported that internet searches for information on electronic cigarettes had the highest volume in the U.S. and UK, compared to snus, NRT, Champix, or Chantix. About 50 to 75% of all searches in the U.S. and UK were shopping searches.
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Canada actively banned e-cigarette sales in 2009. In 2010, Canada saw a significant increase in male smoking prevalence from 22.6% in 2009 to 24.2% in 2010. Female smoking prevalence did not change.
Smoking, 2010
Has there been an uptake in the use of electronic cigarettes in the U.S. that corresponds to the decline in smoking prevalence? Etter and Bullen surveyed 3,587 smokers and former smokers, of which 62% were from the U.S. Their report, published in the journal Addiction, states: Most (96%) said the e-cigarette helped them to quit smoking or reduce their smoking (92%). Reasons for using the e-cigarette included the perception that it was less toxic than
tobacco (84%), to deal with craving for tobacco (79%) and withdrawal symptoms (67%), to quit smoking or avoid relapsing (77%), because it was cheaper than smoking (57%) and to deal with situations where smoking was prohibited (39%). Most ex-smokers (79%) feared they might relapse to smoking if they stopped using the e-cigarette.
Electronic cigarette: users profile, utilization, satisfaction and perceived efficacy - Etter - 2011 - Addiction - Wiley Online Library
Etter and Bullen also reported on health effects of e-cigarette use: Of interest, current smokers who used the e-cigarette had fewer respiratory symptoms than smokers who did not use it (a difference of 0.54 points on the Clinical COPD Questionnaire), which we speculate might be a consequence of reduced smoking. This difference is substantial, as it is larger than the minimally clinically important difference for this questionnaire (0.4 points), and very close to the difference of 0.6 points previously reported between patients with moderate and severe COPD.
In clinical studies, e-cigarettes appear to attenuate craving for tobacco, despite delivering very little nicotine to the blood. (See References below)
References:
EISSENBERG, T. (2010) Electronic nicotine delivery devices: ineffective nicotine delivery and craving suppression after acute administration, Tob Control, 19, 87-8.
VANSICKEL, A. R., COBB, C. O., WEAVER, M. F. & EISSENBERG, T. E. (2010) A clinical laboratory model for evaluating the acute effects of electronic "cigarettes": nicotine delivery profile and cardiovascular and subjective effects, Cancer Epidemiol Biomarkers Prev, 19, 1945-53.
DARREDEAU, C., CAMPBELL, M., TEMPORALE, K. & BARRETT, S. P. (2010) Subjective and reinforcing effects of electronic cigarettes in male and female smokers, Paper presented at the 12th annual meeting of the Society for Research on Nicotine and Tobacco Europe, Bath, UK, September 6-9.
VAN DER MOLEN, T., WILLEMSE, B. W., SCHOKKER, S. et al. (2003) Development, validity and responsiveness of the Clinical COPD Questionnaire, Health Qual Life Outcomes, 1, 13.
