To the Editor We read with great interest the study by Gomajee and colleagues1 that shows an apparent association of regular electronic cigarette (EC) use with decreased smoking levels and increased smoking cessation attempts, as well as an increased risk of smoking relapse in the 2-year follow-up of the France general population. In the recent decade, EC use has become popular as a cessation aid among smokers, yet its effectiveness is still subject to ongoing debate.2,3 The study by Gomajee and colleagues1 represents a step forward toward a better understanding of long-term smoking trajectories after using ECs. We are, however, concerned about whether there is a dose-dependent association between frequency of EC use and smoking level because this study1 focused on only daily use of ECs. It is important to provide substantially more robust reporting of these data to better illuminate the effectiveness of EC use.
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He D, Niu W. More Explorations Needed on Association of Electronic Cigarette Use and Smoking Reduction. JAMA Intern Med. 2020;180(1):160. doi:10.1001/jamainternmed.2019.5272
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