Title: Health outcomes and relapse rates associated with long-term use of e-cigarettes
Funder: Cancer Research UK

Abstract: Background: The question of long-term health effects of a switch from smoking to vaping is currently the number one research priority in this field, but little data on this issue exist. We have recently successfully completed a trial comparing e-cigarettes (EC) and Nicotine replacement treatment (NRT). This generated cohorts of ex-smokers who now vape and who do not vape, and also a cohort of smokers who failed to quit. This provides a rare opportunity to monitor health outcomes of comparable quitters who achieved abstinence from smoking with and without vaping; and to assess whether vaping prevents or promotes relapse back to smoking. Aims: To assess whether on-going EC use (vaping) has any negative effects on health; and whether it prevents or promotes relapse. Methods: In this cohort follow up study, we will contact two groups of previous trial participants: 1) All those who maintained sustained abstinence between 24 and 52 weeks (N=146) and who are still abstinent at point of contact, comprising of participants who switched from smoking to vaping (N=100) and those who stopped smoking without such a switch (N=46); and 2) A sample of consecutive participants who were smoking at least 5 cigarettes/day throughout this period with no more than one months of abstinence, matching the number of abstainers who became long-term vapers. Participants will be contacted every 6 months to complete a survey. They will be asked about their nicotine use (smoking and/or vaping) and their health (visits to GP, hospitalisations, medications used, respiratory symptoms checklist, MRC Breathlessness Scale, respiratory infections, health checklist, QOL overall health rating, self-reported weight changes). Health parameters will be compared in abstainers who do and do not vape and in non-abstainers; and relapse rates will be compared between the first two groups. How the results of this research will be used: The results of this study will contribute to the evidence of long-term health effects of vaping. Another issue that the proposed project would investigate are any effects of vaping on relapse rates. It is not known whether smokers who stop smoking by switching to vaping are at a higher or lower risk of relapse than similar smokers who are not using any nicotine containing products. These issues are of considerable importance for smokers and for policy makers.

Lay abstract: Background: The question of long-term health effects of a switch from smoking to vaping is currently the number one research priority in this field, but little data on this issue exist. We have recently successfully completed a trial comparing e-cigarettes (EC) and Nicotine replacement treatment (NRT). This generated cohorts of ex-smokers who now vape and who do not vape, and also a cohort of smokers who failed to quit. This provides a rare opportunity to monitor health outcomes of comparable quitters who achieved abstinence from smoking with and without vaping; and to assess whether vaping prevents or promotes relapse back to smoking. Aims: To assess whether on-going EC use (vaping) has any negative effects on health; and whether it prevents or promotes relapse. Methods: In this cohort follow up study, we will contact two groups of previous trial participants: 1) All those who maintained sustained abstinence between 24 and 52 weeks (N=146) and who are still abstinent at point of contact, comprising of participants who switched from smoking to vaping (N=100) and those who stopped smoking without such a switch (N=46); and 2) A sample of consecutive participants who were smoking at least 5 cigarettes/day throughout this period with no more than one months of abstinence, matching the number of abstainers who became long-term vapers. Participants will be contacted every 6 months to complete a survey. They will be asked about their nicotine use (smoking and/or vaping) and their health (visits to GP, hospitalisations, medications used, respiratory symptoms checklist, MRC Breathlessness Scale, respiratory infections, health checklist, QOL overall health rating, self-reported weight changes). Health parameters will be compared in abstainers who do and do not vape and in non-abstainers; and relapse rates will be compared between the first two groups. How the results of this research will be used: The results of this study will contribute to the evidence of long-term health effects of vaping. Another issue that the proposed project would investigate are any effects of vaping on relapse rates. It is not known whether smokers who stop smoking by switching to vaping are at a higher or lower risk of relapse than similar smokers who are not using any nicotine containing products. These issues are of considerable importance for smokers and for policy makers.

Research activity codes: 3.1 PRIMARY PREVENTION INTERVENTIONS TO MODIFY BEHAVIOURS OR PROMOTE WELL-BEING
Health categories: CANCER AND NEOPLASMS