A new study from The New England Journal of Medicine and funded by the National Institute for Health Research and Cancer Research UK says that e-cigarettes are nearly twice as effective as other nicotine replacement therapies like patches, gum and nasal spray, a win for harm reduction advocates in our industry. Results were published on January 30.
Our friends at Keller and Heckman broke down the study’s elements:
- It involved 886 adults, chosen randomly, who were already attending at least four weekly counseling sessions at the U.K. National Health Service stop smoking services
- Participants were randomly given either nicotine-replacement products of their choice (gum, lozenges, patches, nicotine inhalers) for up to 3 months or an e-cigarette starter pack consisting of a second-generation refillable e-cigarette and one bottle of 18 mg nic e-liquid
- The e-cigarette group were told to purchase further e-liquids of the flavor and strength of their choice
- Participants using the nicotine replacement products could use multiple products
Over the course of one year, the study compared levels of abstinence, “which were validated biochemically” (researchers measured the quantities of carbon monoxide in the participants’ breath, according to The New York Times).
The e-cigarette group rated at 18 percent abstinence, and the nicotine replacement group rated at 9.9 percent. Participants who did not achieve full abstinence that were in the e-cigarette group “were more likely than those in the nicotine-replacement group to reduce their smoke intake at the one-year point.”
Authors said that the study, more than previous trials, “showed a stronger effect of e-cigarettes.” This trial in particular included face-to-face support, as the groups were already enrolled in the weekly behavioral smoking-cessation program.
Peter Hajek, public health researcher at Queen Mary University of London and one of the researchers on this study, told NPR, "We know that there are millions of smokers out there who successfully stopped smoking by switching to vaping. The e-cigarettes [in the study] were significantly more effective than nicotine replacement treatment. The figure may sound low, but these type of clients would, if they were quitting on their own, the quit rate would be about 3 percent.”
Hajek said that vapers who use e-cigarettes to quit analogs have milder cravings, get pleasure from vaping and also reduce the dose of nicotine they are using over time. Of course, in America, there is more discourse than in the UK. Belinda Borrelli, psychologist and professor at Boston University’s Henry M. Goldman School of Dental Medicine, co-wrote an editorial regarding e-cigarettes and smoking cessation in the New England Journal of Medicine. She says "The good news is that traditional smoking has gone down in these populations.” But she stressed that people who vape to quit smoking “should at least have a plan to get off the e-cigarettes afterward.” Hajek rebutted that it’s easier to quit vaping than smoking, and its risks are lower than that of tobacco usage.
"It would be very similar to drinking coffee," he told NPR. "You have a lot of people who have to have their cup of coffee every day. They do it because there's stimulant drug in it, and it's very similar to using pure nicotine without the toxins, which actually kill people. So from our point of view, on this side of the pond, this is not a public health issue any more. Health professionals have been reluctant to recommend their use because of the lack of clear evidence from randomized controlled trials. This is now likely to change.”
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