Tobacco Center Faculty Blog

April 9, 2018

Stanton A. Glantz, PhD

There have been several studies published recently (the latest is here) showing that daily users of high nicotine delivery e-cigarette systems quit more than people who don’t use e-cigarettes.  These studies also show depressed quitting or no effect of non-daily users of high delivery systems as well as cig-alikes.  Because only a small minority of e-cigarette users (10-20%) are daily users of high delivery systems, the overall population health effect of e-cigarettes on smoking cessation remains negative, i.e., on average smokers who use e-cigarettes are less likely to quit than smokers who do not use e-cigarettes.

In 2016 Sara Kalkhoran and I published a meta-analysis  that considered all the available evidence at the time, which found an overall negative effect of e-cigarette use on smoking cessation.  (In that paper we also suggested that there was some evidence that heavy users of high delivery systems quit more; as noted above, the evidence to support this view had grown stronger.)

Since then I have been updating the meta-analysis every time a new study comes out.  The conclusion that, overall, e-cigarettes depress quitting has been remarkably stable. 

April 7, 2018

Stanton A. Glantz, PhD

Kaitlyn Berry and colleagues just published “E-cigarette initiation and associated changes in smoking cessation and reduction: the Population Assessment of Tobacco and Health Study, 2013–2015,” a well-done analysis of the FDA/NIH path dataset  that concludes that “daily e-cigarette initiators were more likely to have quit smoking or reduced use compared to non-users.  However, less frequent e-cigarette use was not associated with cigarette cessation/reduction.”

This paper adds to the growing body of evidence that the kind of e-cigarette is important as well as how intensely it is used matters.  As they stated in the abstract (quoted above), they only found significantly more quitting among daily e-cigarette users.  An important point in considering how to interpret this result is that only 19% of e-cigarette users are daily users.

April 5, 2018

Stanton A. Glantz, PhD

Mohammed Jawad , several other colleagues, and I recently published “Price elasticity of demand of non-cigarette tobacco products: a systematic review and meta-analysis” in Tobacco Control.  Most studies of the effects of price on tobacco consumption deal with cigarettes.  This paper identified studies of the effect of price on consumption on non-cigarette tobacco products and found, like with cigarettes (and most things) raising price is associated with lower consumption.  The level of price sensitivity (elasticity) is around the same level as cigarettes.  If anything, users of non-cigarette tobacco products are more price sensitive (higher elasticity) than cigarette smokers. 

The policy implication of this work is that tax increases (to increase price and reduce consumption) is good public health policy for nonsmoked tobacco products, too.

Objective To systematically review the price elasticity of demand of non-cigarette tobacco products. Data sources Medline, Embase, EconLit and the Web of Science without language or time restrictions.

March 29, 2018

Stanton A. Glantz, PhD

Nicotine and Tobacco Research just published Lauren Lempert and my paper “Tobacco Industry Promotional Strategies Targeting American Indians/Alaska Natives and Exploiting Tribal Sovereignty” as an “editor’s choice,” which means it is freely available to everyone.  In this paper we detail how the tobacco companies exploited the fact that (a different form of) tobacco is used in some AI/AN ceremonies as well as the fact that tribal sovereignty created places that were not covered by state laws, particularly cigarette taxes and smokefree laws.

Here is the abstract:

Introduction:  American Indians/Alaska Natives have the highest commercial tobacco use in the United States, resulting in higher tobacco-caused deaths and diseases than the general population. Some American Indians/Alaska Natives use commercial tobacco for ceremonial as well as recreational uses. Because federally-recognized Tribal lands are sovereign, they are not subject to state cigarette taxes and smokefree laws. This study analyzes tobacco industry promotional efforts specifically targeting American Indians/Alaska Natives and exploiting Tribal lands to understand appropriate policy responses in light of American Indians’/Alaska Natives’ unique sovereign status and culture.

March 28, 2018

Stanton A. Glantz, PhD

Nancy Rigotti and colleagues just published a well-done study of the effects of e-cigarette use on smoking cessation among a cohort of smokers who planned to stop smoking after being hospitalized.  They randomized smokers into two groups, one that was given an active intervention to help them quit smoking and a control group who just received advice to quit.  Smokers were followed prospectively for 6 months  to examine successful quitting as a function of whether or not the patients used e-cigarettes as well as the assigned therapy.

Only 10.1% of the smokers who used e-cigarettes had quit smoking after 6 months compared to 26.6% of smokers who did not use e-cigarettes.  In other words, smokers who used e-cigarettes while trying to quit had their chances of successfully quitting cut by two thirds.

This is a very strong study because it is done prospectively by a well-respected group.  In addition, Rigotti and her colleagues carefully controlled for differences between the e-cigarette users and non-e-cigarette users and made a strong case that their results were very unlikely to be due to some unobserved confounder.