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E-cigarettes help smokers quit, according to study

E-cigarette user (Annems/dreamstime.com)

More smokers successfully quit using e-cigarettes than over-the-counter NRT

Fresh evidence suggests smokers attempting to quit are more likely to succeed if they use e-cigarettes than if they use nicotine replacement therapy (NRT) or willpower alone.

Research conducted at the University College London (UCL) and published in Addiction on 21 May 2014 found that 20% of smokers said they successfully quit while using e-cigarettes compared with 10.1% using over-the-counter NRT (odds ratio [OR] 2.23, 95% confidence interval 1.7–2.93) and 15.4% using willpower alone (OR 1.38, 95% confidence interval 1.08–1.76). Even after adjusting for a range of smoker characteristics, the difference in success rates persisted, say the authors of the study.

The devices have become increasingly popular in the past couple of years. The UCL researchers say that their results are valuable evidence of the effectiveness of e-cigarettes when used as quitting aids in the real world. The results contradict those from another recently published review, which concluded that e-cigarettes did not help people to quit.

The researchers used data from an ongoing national surveillance programme called the ‘Smoking Toolkit Study’. Each month, the programme interviews a cross-section of people in England and records information on smoking prevalence and behaviour. Use of e-cigarettes as an aid to smoking cessation has been tracked since 2009. The researchers analysed data for 5,863 smokers between 2009 and early 2014 who had made a serious attempt to quit smoking in the 12 months before the interview.

E-cigarette smokers (n=464) were more likely to report currently abstaining from cigarettes than users of NRT (n=1,922) or willpower (n=3,477).

However, the authors point out that the study did not include smokers who attempted to quit with the help of professional support combined with prescribed medication.

“The strongest evidence remains for use of the NHS stop-smoking services, which  almost triple a smoker’s odds of successfully quitting compared with going it alone or relying on over-the-counter products,” says Robert West of UCL’s department of epidemiology and public health and senior author of the study.

Addressing the fact that NRT was the least effective method for quitting smoking, the authors say that this contributes to the debate about “how far medical regulation can go in ensuring that products used for smoking cessation are or continue to be effective in the real world”.

E-cigarettes and their impact on public health has become a hotly debated topic. It has been suggested that they might re-normalise smoking or that dual use may deter smokers from quitting. The evidence presented in the current study does not address these issues, say the researchers.

It is crucial to distinguish between the use of e-cigarettes as aids to quitting and the use of e-cigarettes for any other purpose, such as recreation, and whether this impacts on a person’s likelihood of quitting smoking, they say. “In determining the overall effect on public health, both considerations are important, but they require different methodologies to address them.”

There is currently no licensed e-cigarette product, but they are stocked by some pharmacies. The Royal Pharmaceutical Society advises pharmacies not to stock the products until a licensed version is available.

Citation: The Pharmaceutical Journal URI: 11138576

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