Sir, I am writing in reference to the Potential quitters turn to e-cigarettes Upfront news article1 that was published in a recent issue of the British Dental Journal which seemed to imply that e-cigarettes were undermining smoking cessation attempts. This article was written in reference to a Health and Social Care Information Centre report2 which described the continued fall in the use of the Stop Smoking Services (SSS) and suggested that this 'may be partly' due to increased use of e-cigarettes.

This publication was very timely, because almost within the same week, a study which addressed this exact topic was published in the BMJ.3 This study, the first of its kind, estimated the population impact of e-cigarettes usage by undertaking a time series analysis to explore an association between use of e-cigarettes and changes in quit attempts at a population level. Some key conclusions of this study were that:

  • E-cigarette use by smokers (in England) was positively associated with the success rates of quit attempts

  • No clear association was found between e-cigarette use and the rate of quit attempts or the use of quitting aids (except for NRT obtained on prescription, for which there was a negative association with e-cigarette use).

The authors of the BMJ paper estimated that in 2015 there were 54,288 additional short- to medium-term quitters compared with no use of e-cigarettes in quit attempts, and on the assumption that approximately two-thirds of these may relapse in the future, that e-cigarettes may have contributed about 18,000 additional long term ex-smokers in 2015. The authors point out that although these numbers are relatively small, they are clinically significant given the huge health gains of stopping smoking.

This is obviously an important area and continued careful surveillance of the data relating to e-cigarette usage, quit attempts, and smoking cessation is required. It is also critically important that we investigate further the oral health effects of e-cigarettes, to contribute to these complex discussions.