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E-cigarettes probably don't undermine attempts by tobacco smokers to quit their smoking habit in contrast to conventional wisdom.

On the other hand, the rise in the use of e-cigarettes (or vaping) in England has been linked to a higher rate of successful attempts to quit smoking, said a study published in The BMJ, a weekly peer-reviewed medical journal published by the British Medical Association.

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The study said use of e-cigarettes might have resulted in an additional 18,000 long-term ex-smokers in England in 2015. The authors noted that "although these numbers are relatively small, they are clinically significant because of the huge health gains from stopping smoking."

The results "conflict with the hypothesis that an increase in population use of e-cigarettes undermines quitting in general."

E-cigarette use in quit attempts is negatively associated with use of nicotine replacement therapy (NRT) on prescription, perhaps because patients using e-cigarettes having already tried NRT. The study authors said more research is needed to confirm this.

As with any observational study, however, firm conclusions about cause and effect cannot be drawn, said the study.

No clear evidence emerged for an association between e-cigarette use and rate of quit attempts; the use of nicotine replacement therapy bought over the counter; the overall use of prescription treatment or use of NHS stop-smoking services.

The team of UK based researchers used a time series analysis to explore the relation between changes in prevalence of e-cigarette use and changes in prevalence of quit attempts; the success of those attempts; use of licensed and prescribed medication on prescription and over the counter, and behavioral support.

They also examined data from the Smoking Toolkit Study, which involves monthly household surveys of a representative sample of individuals aged 16 years and older in England. Data was aggregated on 43,000 smokers between 2006 and 2015.

Statistics on the use of NHS stop smoking services were obtained from the NHS Information Centre, which reported a total of 8,029,012 quit dates being set with the program during the same period.

The results suggest that "successful quitting through substitution with electronic cigarettes is a likely contributor to the falling prevalence of smoking," said John Britton from the University of Nottingham.

A number of potential factors--both those measured and unaccounted for --may have influenced the results, and "it therefore remains unclear whether, or by how much, the availability of e-cigarettes has influenced quitting behavior in the UK," he said.