E-cigarettes are more effective than nicotine replacement treatments in achieving long-term smoking reduction and cessation, according to a new research.
The clinical trial was led by the Queen Mary University of London. The findings of the study were published in the journal 'Addiction'.
Some 80% of smokers receiving intensive treatment continue to smoke after a year. Smokers could benefit from approaches that reduce the harm from smoking without ceasing nicotine use, with an option to stop nicotine later on.
Nicotine replacement treatments (NRT), such as nicotine patches, chewing gum, nasal/mouth spray, and inhalators, have been licensed to do this for over 30 years. They work, especially if behavioural support is also provided, but the results are modest.
In the first study of its kind, researchers enrolled 135 smokers who had been unable to stop smoking with conventional treatments. They were randomised to receive either an eight-week supply of NRT of their choice or an e-cigarette starter pack, with instructions to purchase further e-liquids of strength and flavours of their choice for themselves. Products were accompanied by minimal behavioural support to quit smoking.
The results of the study found a significant difference in smoking reduction (including quitting altogether) in the e-cigarette group. After six months, in the e-cigarette group, 27% of the participants had reduced their smoking by at least half, compared to 6 per cent of participants in the NRT group.
A significant difference was also found in rates of stopping smoking altogether, confirmed by carbon monoxide readings from participants' breath - 19% of participants in the e-cigarette group had stopped smoking versus 3% in the NRT group.
The results suggest that recommending a refillable e-cigarette with an e-liquid with the strength and flavour of the patient's choice is a more effective approach for dependent smokers than prescribing NRTs. The e-cigarette starter pack also costs much less than NRTs.
However, concerns around the use of e-cigarettes have been mounting worldwide. In a report published in Lancet Public Health, researchers Joy Kumar Chakma, Hemant Kumar, Stuti Bhargava and Tripti Khanna wrote that "beyond the issue of nicotine addiction, the ingredients used in flavouring agents and additive agents, like propylene glycol and vegetable glycerin, can also be harmful for health. When heated, these additive agents can produce various compounds, including formaldehyde and acetaldehyde, which are carcinogenic to humans. Disposal of waste from e-cigarettes and the manufacture of e-cigarettes could also pose potential environmental hazards. Notably, increased e-cigarettes use among adolescents has been a particular concern,4 and severe lung disease has been associated with the use of e-cigarettes in the USA."
The London researchers found, however, that their cohort showed encouraging results for the role played by e-cigarettes in helping users quit. Lead researcher and Health Psychologist Dr Katie Myers Smith from Queen Mary University of London, said: "These results have important clinical implications for smokers who have previously been unable to stop smoking using conventional treatments. E-cigarettes should be recommended to smokers who have previously struggled to quit using other methods, particularly when there is limited behavioural support available."
Michelle Mitchell, Chief Executive of Cancer Research UK, which funded the study, said: "This study shows e-cigarettes can be a very effective tool for people who want to stop smoking, including those who've tried to quit before. And research so far shows that vaping is far less harmful than smoking. But e-cigarettes aren't risk free, and we don't yet know their long term effects, so people who have never smoked shouldn't use them."