E-cigarette use is strongly associated with recent smoking cessation: an analysis of a representative population sample in Greece

  • Konstantinos FarsalinosEmail author
  • Georgios Siakas
  • Konstantinos Poulas
  • Vassilis Voudris
  • Kyriakoula Merakou
  • Anastasia Barbouni
Part of the following topical collections:
  1. Health Impact of Electronic Cigarettes and Tobacco Heating Systems
  2. Health Impact of Electronic Cigarettes and Tobacco Heating Systems


The purpose was to examine the association between e-cigarette use and smoking cessation according to quit duration in Greece in 2017. A cross-sectional survey of a representative sample of adults living in Attica prefecture was performed in May 2017 through telephone interviews. The present analysis was confined to current and former smokers (n = 2568). Logistic regression analyses were performed with current and current daily e-cigarette use being the dependent variables and demographics and smoking status (current smokers vs smoking cessation for ≤ 12 months, 13–36 months, 36–72 months, and > 72 months) being independent variables. Almost half of former smokers (47.7%) had quit smoking for ≤ 72 months. Current e-cigarette use was more prevalent among former smokers of ≤ 12 months (26.2%) and 13–36 months (27.0%), and was rare among former smokers of > 72 months (1.0%). Current e-cigarette use was strongly associated with smoking cessation for ≤ 12 months (OR 6.12, 95% CI 4.11–9.10, P < 0.001) and 13–36 months (OR 6.28, 95% CI 4.25–9.28, P < 0.001). Current daily e-cigarette use was also strongly associated with smoking cessation for ≤ 12 months (OR 10.41, 95% CI 6.56–16.53, P < 0.001) and 13–36 months (OR 11.18, 95% CI 7.12–17.55, P < 0.001). Current and current daily e-cigarette use were not significantly associated with smoking cessation for 37–72 months, and were negatively associated with smoking cessation for > 72 months. Current and current daily e-cigarette use are strongly associated with recent smoking cessation in Greece, suggesting a positive public health impact in a country with the highest prevalence of smoking in the European Union. E-cigarettes do not appear to promote relapse in long term former smokers. Duration of smoking cessation and frequency of e-cigarette use should be taken into consideration when examining the association between e-cigarette use and smoking cessation in population studies.


Electronic cigarettes Smoking Smoking cessation Nicotine Greece 




Compliance with ethical standards

Conflict of interest

Authors report no conflicts of interest for the past 36 months.

Statement of human and animal rights

This study was approved by the ethics committee of the Onassis Cardiac Surgery Center (reference nr: 591/14.12.16).

Informed consent

All participants provided verbal informed consent at the beginning of the telephone interview before participating to the study.


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Copyright information

© Società Italiana di Medicina Interna (SIMI) 2019

Authors and Affiliations

  1. 1.Onassis Cardiac Surgery CenterKallitheaGreece
  2. 2.Department of PharmacyUniversity of PatrasRioGreece
  3. 3.National School of Public HealthAthensGreece
  4. 4.Public Opinion Research UnitUniversity of MacedoniaThessalonikiGreece

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