Study Finds E-Cigarettes More Effective Than Nicotine Replacement Therapy – Health

Try to stop smoking? Or at least, thinking to try to stop?

According to a new study published today in the New England Journal of Medicine, you may have more luck with electronic cigarettes than nicotine patches or gum.

The clinical trial, which involved nearly 900 smokers in the UK, found that 18% of consumers of electronic cigarettes had become nonsmokers after one year, compared with 9.9% of people using alternatives to smoking. nicotine such as patches, chewing gums, lozenges and sprays.

Principal investigator Peter Hajek, of Queen Mary University in London, said that although electronic cigarettes were commonly used to try to quit smoking, there was not much evidence that They had really helped.

During the trial, participants received either a nicotine replacement product (or combination of products) or a nicotine starter kit, along with one or two e-liquid vials. , and an encouragement to buy future products.

At least four weeks after the trial, participants also received weekly individual behavioral support.

Of those who successfully quit smoking, 80% of e-cigarette users were still marveling after one year, but only 9% of those who received nicotine replacement products still used them.

Hayden McRobbie, co-author of the study, said that even though the long-term vaping risks were unknown, "Continue smoking [was] by far the biggest risk. "

"We want to see smokers change [to vaping]and, ideally, avoid vaping, "said Professor McRobbie, professor of public health interventions at Queen Mary University in London.

"But for people who do not smoke, we do not want them to start to run out of steam."

More effective than leaving cold turkey

Coral Gartner, who heads the scientific research group on the regulation of nicotine and tobacco at the University of Queensland, said the findings of the survey provided "high-level evidence" of the disease. Use of electronic cigarettes as a way to stop smoking.

"This study provides a very good support that [e-cigarettes] are an approach we could use in clinical practice, "said Dr. Gartner, who did not participate in the study.

She stated that dropout rates obtained in the study – 18% for electronic cigarettes and 9.9% for nicotine replacement therapies – were significantly higher than the average success rate of the "cold turkey".

"So, I would see the result of the electronic cigarette – 18% – as very good, because of the low success rate of quitting smoking without help."

According to the researchers, the "greater effects" of the e-cigarettes identified in the study (compared to previous trials) could be due to the inclusion of smokers actively seeking help, to the provision of face-to-face support, and the use of modern and refillable electronic cigarettes.

"It was not," Here's an e-cigarette, good luck! "- People also had behavioral support," said Professor McRobbie.

"The participants were addicted smokers, but they were also people who wanted to quit smoking.

"I think the study shows that e-cigarettes can help you stop smoking, but these are not magic cures … there are other things to put in place to help make this trip." easier."

With respect to why e-cigarettes have been shown to be more effective than other nicotine replacement products, the researchers suggested that vaping allowed people to better adjust their nicotine dose and provided some of the well-known behaviors. of the cigarette.

"Electronic cigarettes have been more effective at relieving tobacco withdrawal symptoms … and have been found to be more useful for quitting smoking than nicotine replacement products," they wrote.

According to the study, further trials were needed to determine whether the results could be generalized beyond the UK's anti-smoking services.

Concerns about long-term use

While abstinence rates were higher among electronic cigarette users at all stages of the trial, the rate of continued use of vaping at the end of 12 months was "quite high". "- 8 out of 10 users were still vaping.

"This can be considered problematic if the use of the electronic cigarette for one year indicates continued long-term use, which may pose unknown health risks," the authors wrote.

This is one of the main concerns of Australian public health experts: there is still not enough evidence to show that vaping is safe, especially in the long run.

Simon Chapman, Emeritus Professor of Public Health at the University of Sydney, recently told ABC: "It will take decades to find out whether vaping is or is less dangerous than smoking and to what extent if not at all. "

A recent CSIRO report found that regular use of e-cigarettes could have "adverse health consequences". However, the report also pointed out that it lacked "clarity as to the magnitude of the adverse health effects and the amount of use of these cigarettes for triggering [them]".

According to Dr. Gartner, there must be a "compromise": accepting the long-term use of electronic cigarettes for "greater success in smoking cessation".

"Obviously, not smoking or vaping will be the safest option, but if someone is trying to quit, it can take many years … and vaping can help it to stop and reduce risks.

"It is about minimizing harm – helping people to move in a continuum of risk, up to a lower level of risk."

Dr. Gartner stated that it is important that people who smoke and vapot together turn exclusively to vaping and, when they can, completely stop vaping.

"I would encourage people using vaping – even as a way to stop smoking – to also stop vaping eventually," she said.

She and Professor McRobbie stated that part of the problem was that the more frequent and longer term use of vaping – as the study shows – was probably "an important factor" in the higher success rate of people who used it to quit.

"We know that the use of long-term nicotine replacement therapy prevents relapse, and that's probably what we're seeing here: vaping prevents relapse," said the Professor McRobbie.

Dr. Gartner stated that while vaping is a low risk behavior, it was not risk free.

"It's a complex and difficult area." It's easy to say "stop: do not use anything" .It's the same with a lot of health behaviors, it's difficult , "she said.

Pushing to rethink regulation

Australia is becoming more and more lonely when it comes to regulating the electronic cigarette.

The sale of nicotine is legal in Britain, New Zealand, the United States and Canada, however, the sale of liquid nicotine is illegal in Australia – a ban confirmed by the Therapeutic Goods Administration (TGA) in 2017.

People who want nicotine in their electronic cigarettes have to order it abroad in liquid form or have access to it through a prescription from their doctor. But very few doctors are willing to prescribe.

"Electronic cigarettes containing nicotine are not available to Australian smokers because no product has been approved as a help to stop smoking," Dr. Gartner said.

In Australia, all anti-tobacco products must have been formally badessed and approved by the TGA.

"Unless something changes drastically, it's basically a stalemate at this point … there's not much point in having a product approved by them," Dr. Gartner said.

She added that, instead of medical regulation, policy makers should "look very seriously at different models", including proposing nicotine-containing electronic cigarettes available as consumer products in a "highly regulated" way with "many checks".

"We currently have the most harmful product available – tobacco cigarettes – sold in supermarkets," she said.

"We have to ask ourselves: is this really appropriate, especially when another product could replace it and would represent a fraction of the risk?"

Professor McRobbie agreed that making vaping available to smokers "but [our] better to limit it to smokers "was" ideal ".

"It's a matter of finding that balance," he said.

Public health experts have expressed concerns about the potential uptake of vaping by young people – and this is a gateway to smoking – if regulation changes.

In September, the US Food and Drug Administration announced plans to ban flavored electronic cigarettes as the country grapples with an "epidemic" of electronic cigarette consumption by young people that threatens to create a new generation of e-cigarettes. addicts to nicotine.

Dr said that it was "really a concern" and that health authorities would need to "monitor very closely".

"I do not think we should necessarily badume that if we change the way we regulate electronic cigarettes, we would see the trend in the United States," she said.

"But it's something we should watch and try to minimize as much as possible."