[Skip to Navigation]
Views 151
Citations 0
Comment & Response
January 2020

More Explorations Needed on Association of Electronic Cigarette Use and Smoking Reduction—Reply

Author Affiliations
  • 1Inserm, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Sorbonne Université, Paris, France
JAMA Intern Med. 2020;180(1):160-161. doi:10.1001/jamainternmed.2019.5275

In Reply In their letter in response to our Original Investigation,1 He and Niu suggest that the association between frequency of electronic cigarette (EC) use and smoking level may be dose dependent, which our study did not investigate. This is a valid point, as frequency of EC use, and therefore the nicotine dose received, might be relevant with regard to smoking cessation. Unfortunately, such measures are difficult to obtain in large cohort studies such as CONSTANCES (Consultants des Centres d’Examens de Santé). Some vapers take a few puffs several times a day, while others use their ECs less frequently but take more puffs each time.2 Additionally, other factors might also influence frequency of EC use, such nicotine dependency, nicotine dose in the e-liquid used, lengths and strength of puffs, as well as context and location of use (eg, festive, social, work, home). Prior studies of smoking cessation have considered daily EC use to be intensive,3,4 yet future research will need to yield more detailed information about the relationship between the level of use and smoking patterns in large community-based samples.

Add or change institution
Limit 200 characters
Limit 25 characters
Conflicts of Interest Disclosure

Identify all potential conflicts of interest that might be relevant to your comment.

Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.

Err on the side of full disclosure.

If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.

Not all submitted comments are published. Please see our commenting policy for details.

Limit 140 characters
Limit 3600 characters or approximately 600 words