Estimating the Effects of Vaping Frequency on Smoking Cessation Using PATH Study Data: A Causal Forest Approach
- 1Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, MI, United States
Abstract
IntroductionE-cigarettes are the second most commonly used nicotine product in the United States after cigarettes. Their role in smoking cessation remains debated. Further research is needed to clarify their potential impact on quitting combustible cigarette use.
MethodsWe analyzed data from adults aged 18 and older who participated in Wave 4 (12/2016-01/2018), Wave 5 (12/2018-11/2019), and Wave 7 (01/2022-04/2023) of the Population Assessment of Tobacco and Health Study. We employed a causal forest to estimate the associations between Wave 5 e-cigarette use and past 12-month cigarette smoking abstinence at Wave 7. Eligible participants had smoked at least 100 cigarettes in their lifetime at Wave 4, currently smoked cigarettes some days or every day at both Waves 4 and 5, completed follow-up at Wave 7, and had a substantial estimated probability of either vaping or not vaping at Wave 5. Analyses adjusted for 26 Wave 4 covariates, including demographic characteristics, tobacco use history, and other relevant factors.
ResultsCompared with no vaping, vaping on 1-5 days was associated with a 2.4 percentage-point lower probability of cessation (95% CI: -7.7 to 2.9), whereas vaping on 6-29 days and daily vaping were associated with increases of 7.5 percentage points (95% CI: -0.4 to 15.5) and 12.5 percentage points (95% CI: 6.2 to 18.7), respectively.
ConclusionsThe association between vaping and smoking cessation varied by vaping frequency. Compared with non-vaping, infrequent vaping was not significantly associated with subsequent cigarette abstinence, whereas more frequent vaping was associated with a greater likelihood of abstinence. Daily vaping showed the strongest positive association.
ImplicationsThis study contributes to the ongoing debate about the role of e-cigarettes in smoking cessation. The findings suggest that vaping frequency may be an important factor in understanding whether e-cigarette use promotes smoking cessation, with more frequent vaping showing stronger associations with subsequent abstinence. Future research should further examine the conditions under which e-cigarette use may facilitate cessation and assess potential heterogeneity across population subgroups.
Related
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- International best practice in the cessation of vaping and non-combustible nicotine use, and barriers, facilitators and treatment preferences: A rapid review
- Association between duration of smoking cessation and depressive symptoms among community-dwelling older adults: a cross-sectional study
- Lung Function and Respiratory Symptoms as Factors Associated with Smoking Cessation Status in a Population-Based Study
- A Polygenic Score for Smoking Persistence Captures Differences in Cessation Age
BibTeX
@misc{le2026estimating,
title = {{Estimating the Effects of Vaping Frequency on Smoking Cessation Using PATH Study Data: A Causal Forest Approach}},
author = {T. T. T. Le and E. Sverdrup and R. Sun and I. Bondarenko and M. Jaffri and E. Jimenez-Mendoza and J. Jeon and A. Leventhal and A. Hyland and K. E. Warner and D. Mendez},
howpublished = {medRxiv},
year = {2026},
month = sep,
doi = {10.64898/2026.09.02.26362051},
url = {https://www.medrxiv.org/content/10.64898/2026.09.02.26362051v1},
note = {CC BY-NC},
}
RIS
TY - UNPB
TI - Estimating the Effects of Vaping Frequency on Smoking Cessation Using PATH Study Data: A Causal Forest Approach
AU - T. T. T. Le
AU - E. Sverdrup
AU - R. Sun
AU - I. Bondarenko
AU - M. Jaffri
AU - E. Jimenez-Mendoza
AU - J. Jeon
AU - A. Leventhal
AU - A. Hyland
AU - K. E. Warner
AU - D. Mendez
PY - 2026
DA - 2026/09/02
PB - medRxiv
DO - 10.64898/2026.09.02.26362051
UR - https://www.medrxiv.org/content/10.64898/2026.09.02.26362051v1
AB - IntroductionE-cigarettes are the second most commonly used nicotine product in the United States after cigarettes. Their role in smoking cessation remains debated. Further research is needed to clarify their potential impact on quitting combustible cigarette use. MethodsWe analyzed data from adults aged 18 and older who participated in Wave 4 (12/2016-01/2018), Wave 5 (12/2018-11/2019), and Wave 7 (01/2022-04/2023) of the Population Assessment of Tobacco and Health Study. We employed a causal forest to estimate the associations between Wave 5 e-cigarette use and past 12-month cigarette smoking abstinence at Wave 7. Eligible participants had smoked at least 100 cigarettes in their lifetime at Wave 4, currently smoked cigarettes some days or every day at both Waves 4 and 5, completed follow-up at Wave 7, and had a substantial estimated probability of either vaping or not vaping at Wave 5. Analyses adjusted for 26 Wave 4 covariates, including demographic characteristics, tobacco use history, and other relevant factors. ResultsCompared with no vaping, vaping on 1-5 days was associated with a 2.4 percentage-point lower probability of cessation (95% CI: -7.7 to 2.9), whereas vaping on 6-29 days and daily vaping were associated with increases of 7.5 percentage points (95% CI: -0.4 to 15.5) and 12.5 percentage points (95% CI: 6.2 to 18.7), respectively. ConclusionsThe association between vaping and smoking cessation varied by vaping frequency. Compared with non-vaping, infrequent vaping was not significantly associated with subsequent cigarette abstinence, whereas more frequent vaping was associated with a greater likelihood of abstinence. Daily vaping showed the strongest positive association. ImplicationsThis study contributes to the ongoing debate about the role of e-cigarettes in smoking cessation. The findings suggest that vaping frequency may be an important factor in understanding whether e-cigarette use promotes smoking cessation, with more frequent vaping showing stronger associations with subsequent abstinence. Future research should further examine the conditions under which e-cigarette use may facilitate cessation and assess potential heterogeneity across population subgroups.
ER -