Transitions in smoking and nicotine use from 2016 to 2017 among a UK cohort of adult smokers and ex-smokers

Abstract

Introduction and aims: Smokers differ in how they smoke and how they stop smoking. Use of nicotine replacement therapy (NRT) and e-cigarettes further diversifies smokers. We aimed to identify and compare latent groups of past-year smokers and to describe longitudinal transitions between the identified groups.

Design and methods: Latent transition analysis of online UK past-year smokers' data (n = 2857) collected in June 2016 and followed-up in October 2017. Latent groups were identified based on participants' smoking, e-cigarette use, NRT use, urges to smoke and last quit attempt. Sociodemographic and smoking characteristics between the groups were compared using Pearson's χ² test and Cramer's V.

Results: Four latent groups of smokers (heavy smokers, light smokers, smokers using NRT, smokers using e-cigarettes) and two recently quit smokers (abstinent ex-smokers, ex-smokers using e-cigarettes) were identified. Nearly half the participants (48.9%) were heavy or light smokers who did not use alternative nicotine products and largely had not tried quitting smoking. Latent groups were relatively stable and transitions to quitting smoking were more probable in groups of smokers using alternative nicotine products. Smokers using NRT transitioned mostly to abstinent ex-smokers, and smokers using e-cigarettes to ex-smokers using e-cigarettes' groups (11.2% and 11.4%, respectively). The abstinent ex-smokers group grew the most at follow-up (+6.3%).

Discussion and conclusions: Nearly half of the participants continued smoking without having tried to reduce harm or quit. Of smokers who transitioned, the majority quit smoking and abstained from nicotine altogether. Use of alternative nicotine products alongside smoking was associated with higher probabilities of becoming an ex-smoker.

Keywords: e-cigarettes; harm reduction; nicotine; nicotine replacement therapy; smoking.