Electronic Cigarettes Help Smokers Quit, Study Finds, But Critics Urge Caution
One out of five smokers was able to quit tobacco cigarettes by inhaling on electronic cigarettes, which still deliver nicotine but in smaller doses, a new study out of the United Kingdom has found.
Those trying to quit smoking cold turkey or with non-prescription nicotine patches or gum were 60 percent more likely to report succeeding if they used, or vaped, e-cigarettes, the U.K. researchers concluded.
“By providing a vapor containing nicotine without tobacco combustion, e-cigarettes appear able to reduce craving and withdrawal associated with abstinence in smokers,” the researchers wrote, “while toxicity testing suggests that they are much safer to the user than ordinary cigarettes.”
And Professor Robert West of University College London and senior author of the study told Business Insider:
“E-cigarettes could substantially improve public health because of their widespread appeal and the huge health gains associated with stopping smoking.”
Created as a way to wean smokers off nicotine and free them from carcinogenic tobacco chemicals, electronic cigarettes hit the U.S. market about five years ago. They’ve now mushroomed into a nearly $2-billion industry that’s forecast to overtake traditional cigarette smoking globally within a decade, according to Bonnie Herzog, Wells Fargo Securities’ senior tobacco industry analyst. With the market entrance of Big Tobacco and its huge money, distribution systems and branding horsepower, industry growth may accelerate even faster, her team has told investors.
The U.K. researchers billed their work as key due to its “real world” findings. However, the study has some asterisks, which the British government’s National Health Service noted, particularly that the research was not conducted with a randomized and controlled trial, which is the best way to assess the effectiveness of treatments, but rather was based upon people reporting that they had quit, the government health site stated.
“It also relied on people reporting quitting, but they may not have actually done so; self-reporting is not the most reliable of methods,” the researchers said. “Finally, it did not compare e-cigarettes against medications, such as Champix (varenicline), and psychological interventions. This makes it unclear how e-cigarettes compare to these methods.”
The report, “Real-World Effectiveness of E-Cigarettes When Used to Aid Smoking Cessation: A Cross-Sectional Population Study,” was published June 10 in the journal Addiction.
Some 5,863 smokers who’d tried to quit smoking cold turkey and sans professional help, nicotine replacement or prescription medication, were surveyed between 2009 and 2014 as part of an ongoing tracking of English smokers called the Smoking Toolkit Study.
The researchers in the latest report studied those survey responses gathered from July 2009 — when electronic cigarettes were brand new — to February 2014 from smokers who reported trying to quit at least once in the prior year. To make it easier, they focused on three groups of would-be quitters: E-cigarette-only users (8 percent of the sample group); those who used only non-prescription nicotine replacement items such as nicotine patches or gum (33 percent of the sample group), and people who went without smoking-cessation aids (59 percent of the sample).
One out of five people trying to quit with the aid of e-cigarette devices reported having stopped using tobacco cigarettes at the time of the survey. Of those using non-prescription nicotine replacement therapy, 10 percent reported that they had been able to stop smoking. Fifteen percent of smokers reported they had quit successfully with no help. The researchers did control for things such as age, gender, socioeconomic status and to what degree the subject was addicted to nicotine. In the end, the researchers found that those who used electronic cigarettes were 1.63 times more likely to successfully quit smoking than those who chose nicotine replacement products like gum and patches. And the e-cigarette vapers were 1.61 times more likely to quit successfully than smokers who used no aids.
Fans and supporters of e-cigarettes note that some nicotine is better than a lot of nicotine in cigarettes, plus e-cigs lack the hundreds of chemicals cigarette smokers ingest when tobacco is burned.
FDA Steps In
The unfettered sale and access of the nicotine-loaded e-cigarette may soon change (non-nicotine liquid is also popular and it clouds the whole e-cig sales issue).
Because the health impacts of e-cigarettes are unknown, the U.S. Food and Drug Administration has announced proposed regulations of electronic cigarettes. An FDA spokeswoman said the agency is seeking to regulate the devices by defining them as a tobacco product on the grounds that they often contain nicotine, derived from tobacco.
That came fresh off of last fall’s report by the Centers for Disease Control and Prevention that e-cigarettes had been tried by double the number of middle and high school students from 2011 to 2012. Despite the overall percentages being relatively low, and even lower among non-smoking youth, the fact that any juveniles were experimenting with a potential nicotine delivery system fueled widespread calls, including by more than 40 state attorneys general, for FDA action.
Those who favor regulating e-cig sales note that the science is not all in on the health impacts and worry that the devices will be used to hide a nicotine habit or other products that might be consumed in them.
The research, those opponents note, must be weighed against the electronic cigarette’s ability to mask the smell of marijuana, which has contributed to their rocketing sales. The devices use a battery to heat a cartridge of liquid, which may or may not contain nicotine. The vapor from the liquid is inhaled, replacing the sensation of cigarette smoke.
Other research indicates that the vaping devices may serve as a gateway for further nicotine use among teenagers and younger children. The results from a survey published in December 2013 shed some insight on how doctors and parents of teens feel about the rise of e-cigarette use.
Between 2011 and 2012, the use rate for e-cigarettes among American teenagers rose from 3 percent to 7 percent. In November 2013, University of Michigan researchers used an annual project called the C.S. Mott Children’s Hospital National Poll on Children’s Health to examine how parents and other adults across the U.S. feel about the increasing use of e-cigarettes.
Those researchers, who polled 2,124 adults age 18 and older, found that 44 percent of adults believe e-cigarettes will encourage kids to use tobacco products. They also found that nearly half of all adults (48 percent) are either “somewhat” afraid or “very” afraid that their children will start using e-cigarettes. In addition, 65 percent of adults believe that e-cigarette manufacturers should follow the same labeling and health warning guidelines as the manufacturers of tobacco cigarettes and other products that contain nicotine.
E-cigarette enthusiasts counter that the vaping helped them kick the nicotine habit, that they “smoke” non-nicotine or greatly reduced levels of nicotine with the devices, and that any reduction in the use of tobacco cigarettes will save lives and reduce healthcare costs.