Is use of novel smokeless tobacco products associated with smoking cessation among US smokers?

Background: Tobacco companies' expansion into smokeless market and aggressive marketing of electronic cigarettes are increasing the use of alternative tobacco products. The effects of these products on smoking cessation are unknown, and they are not approved for this purpose. We examine rates of trial and current use of these products among smokers and their association with smoking cessation. Methods: Online cross-sectional survey of a nationally representative sample of 1,836 current or recently former (quit within last two years) smokers. Results: Overall, 44% of smokers had tried and 30% expressed interest in alternative tobacco products to reduce health risk, cut down, or quit smoking. E-cigarettes had been tried most and dissolvable tobacco products had been tried least frequently. Men used traditional smokeless and snus tobacco products more frequently than women (p<.001); women used e-cigarettes more frequently (p<0.05), and use of hookah and dissolvable tobacco did not differ by gender. Ever using an alternative tobacco product was associated with having made a cigarette quit attempt in the past year (OR=1.47, 95%CI [1.20, 1.80]), as was current use of any product (OR=1.30 [1.06, 1.59]). Smokers who intend to quit in the next 6 months were significantly more likely to have tried smokeless products and to have used them in the past 30 days than smokers with no intentions to quit smoking. Conclusions: Many smokers in the USA have tried alternative tobacco products, and e-cigarettes were tried the most frequently. Alternative tobacco product use is associated with intending and attempting to quit smoking.