{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T18:13:12Z","timestamp":1790878392040,"version":"4.1.0"},"reference-count":46,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2025,7,25]],"date-time":"2025-07-25T00:00:00Z","timestamp":1753401600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000054","name":"US National Cancer Institute","doi-asserted-by":"crossref","award":["P01 CA200512"],"award-info":[{"award-number":["P01 CA200512"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"crossref"}]},{"name":"National Health and Medical Research Council of Australia","award":["APP1106451"],"award-info":[{"award-number":["APP1106451"]}]},{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["FDN-148477"],"award-info":[{"award-number":["FDN-148477"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"US National Cancer Institute","doi-asserted-by":"crossref","award":["P01 CA200512"],"award-info":[{"award-number":["P01 CA200512"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,11,23]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>E-cigarettes are an increasingly popular method of smoking cessation assistance; however, there is little research on whether this has affected the number of smokers who quit using \u201cany\u201d evidence-based cessation aid. This study examined trends in the use of cessation aids, including e-cigarettes and other evidence-based methods.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims and Methods<\/jats:title>\n                    <jats:p>Data were cross-sectional surveys in 2016, 2018, and 2020 from the International Tobacco Control Four Country Smoking and Vaping Survey conducted in Canada, United States (US), England, and Australia. Respondents were adults (\u226518) recruited by commercial panel firms who currently smoked, and\/or quit smoking in the past 12 months. Respondents were asked about use of e-cigarettes, nicotine replacement therapies, prescription medications, quitlines, and counseling services during their last quit attempt (LQA). Generalized estimating equation regression models that were analyzed separately by country examined use of cessation assistance among 14\u2009536 observations (Canada\u2009=\u20094880; US\u2009=\u20092917; England\u2009=\u20094846; and Australia\u2009=\u20091898).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>E-cigarettes (29.9%) and nicotine replacement therapy (29.8%) were popular methods of cessation assistance at LQA. Using e-cigarettes at LQA increased in Australia (2016\u2009=\u200911.1%; 2020\u2009=\u200925.1%; p=.002) and England (2016\u2009=\u200937.1%; 2018\u2009=\u200946.7%; p=.002), with no significant change in Canada or the US. Across all countries, there was little change over time in the overall use of evidence-based cessation assistance. Nearly half of respondents used some form of cessation assistance excluding e-cigarettes. Approximately two-thirds used \u201cany\u201d form of evidence-based cessation including e-cigarettes at LQA, which decreased in Canada (2016\u2009=\u200964.0%, 2020\u2009=\u200958.9%; p=.010).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>While e-cigarettes are a popular cessation aid, use of other evidence-based cessation assistance has remained comparatively stable among adults that tried to quit smoking.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Implications<\/jats:title>\n                    <jats:p>The findings indicated that e-cigarettes are a popular cessation method among adults trying to quit smoking. Despite differences in e-cigarette use and regulatory environments in the four countries, rates of evidence-based cessation assistance were similar across countries and over time. E-cigarettes can be an effective method for stopping smoking; however, the current study suggests few, if any, changes in the proportion of adults who smoke using any evidence-based form of cessation assistance, despite changes in the use of e-cigarettes as a quit aid.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ntr\/ntaf152","type":"journal-article","created":{"date-parts":[[2025,7,25]],"date-time":"2025-07-25T11:41:31Z","timestamp":1753443691000},"page":"2213-2222","source":"Crossref","is-referenced-by-count":5,"title":["Trends in the Use of Vaping Products and Other Smoking Cessation Methods Among Adults Who Attempt to Stop Smoking: Findings From the International Tobacco Control Four-Country Smoking and Vaping Surveys (2016\u20132020)"],"prefix":"10.1093","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3498-0038","authenticated-orcid":false,"given":"Kimberly","family":"D\u2019Mello","sequence":"first","affiliation":[{"name":"School of Public Health Sciences, Faculty of Health, University of Waterloo , Waterloo, Ontario ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2320-0999","authenticated-orcid":false,"given":"Pete","family":"Driezen","sequence":"additional","affiliation":[{"name":"School of Public Health Sciences, Faculty of Health, University of Waterloo , Waterloo, Ontario ,","place":["Canada"]},{"name":"Department of Psychology, University of Waterloo , Waterloo, Ontario ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9083-2131","authenticated-orcid":false,"given":"Katherine A","family":"East","sequence":"additional","affiliation":[{"name":"Department of Primary Care and Public Health, Brighton and Sussex Medical School, University of Brighton and University of Sussex , Brighton ,","place":["United Kingdom"]},{"name":"National Addiction Centre, Institute of Psychiatry, Psychology & Neuroscience, Kings College London , London ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geoffrey T","family":"Fong","sequence":"additional","affiliation":[{"name":"School of Public Health Sciences, Faculty of Health, University of Waterloo , Waterloo, Ontario ,","place":["Canada"]},{"name":"Department of Psychology, University of Waterloo , Waterloo, Ontario ,","place":["Canada"]},{"name":"Ontario Institute for Cancer Research , Toronto, Ontario ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8197-6010","authenticated-orcid":false,"given":"David","family":"Hammond","sequence":"additional","affiliation":[{"name":"School of Public Health Sciences, Faculty of Health, University of Waterloo , Waterloo, Ontario ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,7,25]]},"reference":[{"key":"2025112403465432600_ref1","volume-title":"WHO Report on the Global Tobacco Epidemic, 2008: The MPOWER Package [Internet]","author":"World Health Organization (WHO)","year":"2008"},{"key":"2025112403465432600_ref2","first-page":"700","volume-title":"Smoking Cessation: A Report of the Surgeon General","author":"U.S. Department of Health and Human Services","year":"2020"},{"issue":"3","key":"2025112403465432600_ref3","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1001\/jama.2020.25019","article-title":"Interventions for tobacco smoking cessation in adults, including pregnant persons: US preventive services task force recommendation statement","volume":"325","author":"US Preventative Services Task Force","year":"2021","journal-title":"JAMA"},{"key":"2025112403465432600_ref4","volume-title":"Tobacco in Australia: Facts and Issues [Internet]","author":"Greenhalgh","year":"2021"},{"key":"2025112403465432600_ref5","volume-title":"Quitting Smoking: How to Quit","author":"Health Canada","year":"2021"},{"key":"2025112403465432600_ref6","volume-title":"Tobacco: Preventing Uptake, Promoting Quitting and Treating Dependence\u2014NICE Guideline [NG209] [Internet]","author":"National Institute for Health and Care Excellence (NICE)","year":"2023"},{"issue":"1","key":"2025112403465432600_ref7","first-page":"CD010216","article-title":"Electronic cigarettes for smoking cessation","volume":"1","author":"Lindson","year":"2024","journal-title":"Cochrane Database Syst Rev"},{"issue":"2","key":"2025112403465432600_ref8","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1093\/ntr\/ntu200","article-title":"A longitudinal study of electronic cigarette use among a population-based sample of adult smokers: association with smoking cessation and motivation to quit","volume":"17","author":"Biener","year":"2015","journal-title":"Nicotine Tob Res"},{"issue":"5","key":"2025112403465432600_ref9","doi-asserted-by":"crossref","first-page":"728","DOI":"10.1093\/ntr\/ntz114","article-title":"Electronic cigarette use and cigarette abstinence over 2 years among U.S. smokers in the population assessment of tobacco and health study","volume":"22","author":"Kalkhoran","year":"2020","journal-title":"Nicotine Tob Res"},{"issue":"5","key":"2025112403465432600_ref10","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1093\/ntr\/ntz025","article-title":"E-cigarettes and smoking cessation in the United States according to frequency of E-cigarette use and quitting duration: analysis of the 2016 and 2017 national health interview surveys","volume":"22","author":"Farsalinos","year":"2020","journal-title":"Nicotine Tob Res"},{"key":"2025112403465432600_ref11","doi-asserted-by":"crossref","first-page":"e079016","DOI":"10.1136\/bmj-2023-079016","article-title":"Trends in long term vaping among adults in England, 2013-23: population based study","volume":"386","author":"Jackson","year":"2024","journal-title":"BMJ"},{"issue":"1","key":"2025112403465432600_ref12","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1136\/tc-2023-058241","article-title":"Trends in vaping and nicotine product use among youth in Canada, England and the USA between 2017 and 2022: evidence to inform policy","volume":"34","author":"Hammond","year":"2025","journal-title":"Tob Control"},{"key":"2025112403465432600_ref13","volume-title":"Smoking and Tobacco Use","author":"US Centers for Disease Control and Prevention","year":"2025"},{"key":"2025112403465432600_ref14","volume-title":"Vaping and Quitting Smoking","author":"Health Canada","year":"2022"},{"key":"2025112403465432600_ref15","volume-title":"Vaping to Quit Smoking\u2014Better Health","author":"National Health Service UK","year":"2022"},{"issue":"14","key":"2025112403465432600_ref16","first-page":"E32","article-title":"Quit methods used by US adult cigarette smokers, 2014\u20132016","volume":"14","author":"Caraballo","year":"2017","journal-title":"Prev Chronic Dis"},{"key":"2025112403465432600_ref17","volume-title":"Canadian Tobacco and Nicotine Survey (CTNS): 2020. Detailed Tables","author":"Health Canada","year":"2022"},{"issue":"10","key":"2025112403465432600_ref18","doi-asserted-by":"crossref","first-page":"1699","DOI":"10.1093\/ntr\/ntab068","article-title":"Self-reported quit aids and assistance used by smokers at their most recent quit attempt: findings from the 2020 international tobacco control four country smoking and vaping survey","volume":"23","author":"Gravely","year":"2021","journal-title":"Nicotine Tob Res"},{"issue":"7","key":"2025112403465432600_ref19","doi-asserted-by":"crossref","first-page":"826","DOI":"10.1093\/ntr\/ntae007","article-title":"Associations of prevalence of e-cigarette use with quit attempts, quit success, use of smoking cessation medication, and the overall quit rate among smokers in England: a time-series analysis of population trends 2007\u20132022","volume":"26","author":"Jackson","year":"2024","journal-title":"Nicotine Tob Res"},{"key":"2025112403465432600_ref20","article-title":"Canadian tobacco and nicotine survey (CTNS): summary of results for 2022","author":"Health Canada","year":"2023"},{"key":"2025112403465432600_ref21","first-page":"124","volume-title":"Tobacco Use in Canada: Patterns and Trends","author":"Reid","year":"2022"},{"key":"2025112403465432600_ref22","article-title":"Prevalence of smoking and smoking cessation among Canadians 15+, 2017","author":"Canadian Community Health Survey","year":"2021"},{"issue":"11","key":"2025112403465432600_ref23","doi-asserted-by":"crossref","first-page":"1727","DOI":"10.1093\/ntr\/ntac115","article-title":"Monitoring the increase in the U.S. smoking cessation rate and its implication for future smoking prevalence","volume":"24","author":"M\u00e9ndez","year":"2022","journal-title":"Nicotine Tob Res"},{"issue":"36","key":"2025112403465432600_ref24","doi-asserted-by":"crossref","first-page":"102440","DOI":"10.1016\/j.pmedr.2023.102440","article-title":"Smoking cessation prevalence by menthol cigarette use and select demographics among adults in the United States, TUS-CPS, 2003\u20132019","volume":"36","author":"Jones","year":"2023","journal-title":"Prev Med Rep"},{"issue":"9","key":"2025112403465432600_ref25","doi-asserted-by":"crossref","first-page":"875","DOI":"10.1136\/thoraxjnl-2018-212740","article-title":"\u201cS\u201d-shaped curve: modelling trends in smoking prevalence, uptake and cessation in Great Britain from 1973 to 2016","volume":"74","author":"Beard","year":"2019","journal-title":"Thorax"},{"issue":"5","key":"2025112403465432600_ref26","doi-asserted-by":"crossref","first-page":"961","DOI":"10.1111\/add.14851","article-title":"Association of prevalence of electronic cigarette use with smoking cessation and cigarette consumption in England: a time\u2013series analysis between 2006 and 2017","volume":"115","author":"Beard","year":"2020","journal-title":"Addict Abingdon Engl"},{"key":"2025112403465432600_ref27","volume-title":"Tobacco Use in Canada: Patterns and Trends, 2019 Edition","author":"Reid","year":"2019"},{"key":"2025112403465432600_ref28","doi-asserted-by":"crossref","first-page":"106376","DOI":"10.1016\/j.ypmed.2020.106376","article-title":"Do e-cigarette sales reduce the demand for nicotine replacement therapy (NRT) products in the US? Evidence from the retail sales data","volume":"145","author":"Huang","year":"2021","journal-title":"Prev Med"},{"key":"2025112403465432600_ref29","volume-title":"ITC Four Country Smoking and Vaping Survey, Wave 3 (4CV3, 2020) Technical Report","author":"ITC Project","year":"2021"},{"key":"2025112403465432600_ref30","volume-title":"Smoking and Health 2021: A Coming of Age for Tobacco Control?","author":"Royal College of Physicians","year":"2021"},{"key":"2025112403465432600_ref31","volume-title":"National Drug Strategy Household Survey 2022\u20132023: Tobacco Smoking in the NDSHS","author":"Australian Institute of Health and Welfare","year":"2024"},{"issue":"1","key":"2025112403465432600_ref32","doi-asserted-by":"crossref","first-page":"e2454962","DOI":"10.1001\/jamanetworkopen.2024.54962","article-title":"Prevalence of popular smoking cessation aids in England and associations with quit success","volume":"8","author":"Jackson","year":"2025","journal-title":"JAMA Netw Open"},{"issue":"358","key":"2025112403465432600_ref33","doi-asserted-by":"crossref","first-page":"j3262","DOI":"10.1136\/bmj.j3262","article-title":"E-cigarette use and associated changes in population smoking cessation: evidence from US current population surveys","volume":"26","author":"Zhu","year":"2017","journal-title":"BMJ"},{"key":"2025112403465432600_ref34","article-title":"Effectiveness of e-cigarettes as aids for smoking cessation: evidence from the PATH study cohort, 2017\u20132019","volume":"32","author":"Chen","year":"2022","journal-title":"Tob Control"},{"issue":"9","key":"2025112403465432600_ref35","doi-asserted-by":"crossref","first-page":"1531","DOI":"10.1111\/add.12623","article-title":"Real-world effectiveness of e-cigarettes when used to aid smoking cessation: a cross-sectional population study","volume":"109","author":"Brown","year":"2014","journal-title":"Addiction"},{"issue":"2","key":"2025112403465432600_ref36","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1177\/29767342231218533","article-title":"Perceiving e-cigarettes as safe and safer alternative to cigarettes among young adults","volume":"45","author":"Ceasar","year":"2024","journal-title":"Subst Use Addict J"},{"issue":"2","key":"2025112403465432600_ref37","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1016\/j.amepre.2007.09.033","article-title":"Use of smoking-cessation treatments in the United States","volume":"34","author":"Shiffman","year":"2008","journal-title":"Am J Prev Med"},{"issue":"8","key":"2025112403465432600_ref38","doi-asserted-by":"crossref","first-page":"1403","DOI":"10.1111\/j.1360-0443.2009.02639.x","article-title":"Factors associated with the use of aids to cessation in English smokers","volume":"104","author":"Kotz","year":"2009","journal-title":"Addiction"},{"issue":"149","key":"2025112403465432600_ref39","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1016\/j.drugalcdep.2015.02.003","article-title":"Predicting use of assistance when quitting: a longitudinal study of the role of quitting beliefs","volume":"149","author":"Myers","year":"2015","journal-title":"Drug Alcohol Depend"},{"issue":"4","key":"2025112403465432600_ref40","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1016\/S0749-3797(00)00124-0","article-title":"Smoking cessation with and without assistance: a population-based analysis","volume":"18","author":"Zhu","year":"2000","journal-title":"Am J Prev Med"},{"issue":"1","key":"2025112403465432600_ref41","first-page":"ntw273","article-title":"Unassisted quitting and smoking cessation methods used in the United States: analyses of 2010\u20132011 tobacco use supplement to the current population survey data","volume":"20","author":"Soulakova","year":"2017","journal-title":"Nicotine Tob Res"},{"issue":"9","key":"2025112403465432600_ref42","doi-asserted-by":"crossref","first-page":"2504","DOI":"10.1111\/add.15903","article-title":"Prevalence of use and real-world effectiveness of smoking cessation aids during the COVID-19 pandemic: a representative study of smokers in England","volume":"117","author":"Jackson","year":"2022","journal-title":"Addict Abingdon Engl"},{"issue":"5","key":"2025112403465432600_ref43","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1093\/ntr\/ntq258","article-title":"Seasonality in sales of nicotine replacement therapies: patterns and implications for tobacco control","volume":"13","author":"Chandra","year":"2011","journal-title":"Nicotine Tob Res"},{"key":"2025112403465432600_ref44","doi-asserted-by":"crossref","first-page":"e2880","DOI":"10.2196\/jmir.2880","article-title":"Impact of seasonality on recruitment, retention, adherence, and outcomes in a web-based smoking cessation intervention: randomized controlled trial","volume":"15","author":"Graham","year":"2013","journal-title":"J Med Internet Res"},{"issue":"9","key":"2025112403465432600_ref45","doi-asserted-by":"crossref","first-page":"1578","DOI":"10.1093\/ntr\/ntt025","article-title":"The quitting rollercoaster: how recent quitting history affects future cessation outcomes (data from the international tobacco control 4-country cohort study)","volume":"15","author":"Partos","year":"2013","journal-title":"Nicotine Tob Res"},{"issue":"6","key":"2025112403465432600_ref46","doi-asserted-by":"crossref","first-page":"e011045","DOI":"10.1136\/bmjopen-2016-011045","article-title":"Estimating the number of quit attempts it takes to quit smoking successfully in a longitudinal cohort of smokers","volume":"6","author":"Chaiton","year":"2016","journal-title":"BMJ Open"}],"container-title":["Nicotine and Tobacco Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ntr\/advance-article-pdf\/doi\/10.1093\/ntr\/ntaf152\/63845097\/ntaf152.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ntr\/article-pdf\/27\/12\/2213\/63845097\/ntaf152.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ntr\/article-pdf\/27\/12\/2213\/63845097\/ntaf152.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T08:47:02Z","timestamp":1763974022000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ntr\/article\/27\/12\/2213\/8212269"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,25]]},"references-count":46,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2025,7,25]]},"published-print":{"date-parts":[[2025,11,23]]}},"URL":"https:\/\/doi.org\/10.1093\/ntr\/ntaf152","relation":{},"ISSN":["1469-994X"],"issn-type":[{"value":"1469-994X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,12]]},"published":{"date-parts":[[2025,7,25]]}}}