Reported patterns of vaping to support long-term abstinence from smoking: a cross-sectional survey of a convenience sample of vapers

Background: E-cigarettes are the most popular aid to smoking cessation attempts in England and the United States of America. This research examined associations between e-cigarette device characteristics and patterns of use, tobacco smoking relapse and smoking abstinence. Methods: A convenience sample of 371 participants with experience of vaping, and tobacco smoking abstinence and/or relapse completed an online cross-sectional survey about e-cigarettes. Factors associated with smoking relapse were examined using multiple linear and logistic regression models. Results: Most participants were self-reported long-term abstinent smokers (86.3%) intending to continue vaping. Most initiated e-cigarette use with a vape pen (45.8%) or cig-a-like (38.7%) before moving onto a tank device (89%). Due to missing data, managed through pairwise deletion, only around 70 participants were included in some of the main analyses. Those using a tank or vape pen appeared less likely to relapse than those using a cig-a-like (tank vs. cig-a-like OR=0.06, 95% CI 0.01 to 0.64, p=0.019). There was an inverse association between starting self-reported e-cigarette liquid nicotine concentration and relapse, interacting with device type (OR=0.79, 95% CI 0.63 to 0.99, p=0.047), suggesting risk of relapse may have been greater if starting with a low e-cigarette liquid nicotine concentration and/or cig-a-like device. Participants reported moving from tobacco flavoured cig-a-likes to fruit/sweet/food flavours with tank devices. Conclusions: Knowledge of how people have successfully maintained tobacco smoking abstinence using vaping could help other tobacco smokers wishing to quit tobacco smoking through vaping.