E-cigarettes “modestly effective” tool to quit smoking

Electronic cigarettes are “modestly effective” at helping smokers quit, according to one of the first randomized controlled trials to examine the efficacy of the increasingly popular but largely unproven smoking cessation product.

Conducted in Auckland, New Zealand, over a 22-month period, the study involved 657 smokers who wanted to quit (Lancet doi:10.1016/S0140-6736(13)61842-5). Participants received nicotine electronic cigarettes (e-cigarettes), nicotine patches or placebo e-cigarettes. Abstinence after six months was highest in the nicotine e-cigarette group (7.3%), followed by patches (5.8%) and placebo (4.1%). No significant differences in adverse events were seen between the groups.

“E-cigarettes are more attractive than patches to many smokers,” Peter Hajek, director of the Tobacco Dependence Research Unit at the Barts and The London School of Medicine and Dentistry in the United Kingdom, wrote in a linked editorial (Lancet doi:10.1016/S0140-6736(13)61534-2).

The product can be obtained with few restrictions in many areas and is frequently regulated as a tobacco product rather than medicine, so a trip to a medical professional for a prescription may not be necessary. “These advantages suggest that e-cigarettes have the potential to increase rates of smoking cessation and reduce costs to quitters and to health services,” added Hajek.

But it’s not only quitters who are taking up the e-cigarette habit. In US schools, for example, there is a growing number of nonsmokers using the product. In 2012, 9.3% of e-cigarette users in grades 6–12 reported that they had never smoked regular cigarettes, according to a report by the Centers for Disease Control and Prevention. Overall, during the year 2011–12, use of e-cigarettes among students in US middle and high schools increased from 3.3% to 6.8%.

E-cigarettes are more attractive than nicotine patches for many smokers, say some researchers.

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“Why would anyone be surprised to see rapid attraction by smoking and nonsmoking adolescents to electronic gadgetry that comes with its own subculture, parent-worrying potential and a built-in argument that it’s not as bad as cigarettes?,” Simon Chapman, professor of public health at the University of Sydney in Australia, writes in an email.

Though the health effects of non-smokers taking up e-cigarettes is unknown, this trend may not actually be of major concern, suggests Jean-François Etter, a professor at the Institute of Social and Preventive Medicine, University of Geneva, in Switzerland. “Yes, the number of never-smokers trying e-cigarettes is increasing, but according to available surveys, experimenters do not seem to convert to regular use or daily use.”