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http://www.bmj.com/content/358/bmj.j3262" target="_blank";Zhu and colleagues' conclusion that e-cigarettes were associated with significantly more quitting smoking was limited to recent (in the last year) quitters.
 
Table 3 of their paper also reports results for people who quit smoking more than 1 year ago.  I analyzed those data and found that among people who quit smoking 1-5 years ago, people who currently used e-cigarettes were about 30% less likely to still be nonsmokers than people who did not use e-cigarettes.
 
This result suggests to me that, among people who quit smoking, continuing to use e-cigarettes is associated with more relapse to cigarettes.
 
This is a question that merits more attention in longitudinal studies.  (Zhu et al is cross-sectional.)  But, in the meantime, policymakers need to consider the possibilty of increases in long-term relapse to smoking among e-cigarette users.  This is also another reason to tell people who manage to quit smoking using e-cigarettes (or think they accomplished it with e-cigarettes) that they need to stop the e-cigarettes as soon as possible, too.
 
 

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