Published: Sat, February 02, 2019
Medicine | By Tracy Klein

E-cigarettes help more smokers quit, study finds

E-cigarettes help more smokers quit, study finds

People who used e-cigarettes to stop smoking had almost twice the one-year abstinence rate of those who used nicotine-replacement therapy, according to a study published Wednesday in The New England Journal of Medicine. Second-hand smoke can be especially harmful to children, and CDC estimates that second-hand smoke caused more than 7,300 deaths from lung cancer every year from 2005 to 2009.

Matthew Myers of the Campaign for Tobacco-Free Kids noted that the British study used so-called tank-based e-cigarettes, which allow users to customize their flavors and nicotine levels.

More than 43,000 current young smokers started using tobacco after they had experimented with e-cigarettes during the two-year period of the study, the study authors estimated.

Youth e-cigarette use rose 78 percent among high school students from 2017 to 2018, according to results from the Centers for Disease Control and Prevention's 2018 National Youth Tobacco Survey. Vaping (or NRT use) after quitting may prevent an ex-smoker from reaching for a cigarette later.

In the United States and Britain, cigarette smoking is the leading preventable cause of death, taking some 480,000 lives each year in the U.S. and more than 100,000 in Britain.

That's why the researchers recommend smokers use FDA-approved NRTs to quit smoking first, and then turn to e-cigs only as a last resort - and either method should be accompanied by behavioral therapy.

They said staff at stop-smoking services have been too reluctant to endorse e-cigarettes, because they have been cautious about the evidence behind them. Vapers were likely to become hooked on e-cigarettes, which are thought to be less harmful than tobacco but aren't without risks.

A major clinical trial conducted by researchers from Queen Mary University of London found that "vaping" pushed twice as many people off cigarettes one year later than users of other products.

Ian Armitage was skeptical about e-cigarettes as a way to stop smoking, saying he tried vaping several years ago but gave it up after experiencing twitching and shakes from nicotine withdrawal. Improved nicotine delivery helps account for the higher quit rate in the new study, which bodes well for Juul, the leading e-cigarette in the USA market.

"Australia can catch up with Canada, New Zealand, the United States, and the United Kingdom and legalise smoke-free alternatives to help smokers quit for good".

Among trial participants who didn't quit smoking, 40 percent of the vaping group continued to vape and smoke ("dual use"), while just 4 percent of the NRT group kept using NRT.

Electronic cigarettes, which have been available in the USA since about 2007 and have grown into a $6.6 billion-a-year industry, are battery-powered devices that typically heat a flavored nicotine solution into an inhalable vapor.

Professor Mendelsohn said smoking rates in Australia had stalled since 2013 and vaping was a potential lifesaver for smokers who were unable to quit with conventional treatments.

The researchers said no serious adverse events were related to either NRT use or e-cigarette use.

Prof Hajek said he hoped the results of the study would lead to stop-smoking services offering quitters an e-cigarette starter pack and guidance on how to vape, after which they could pay for their own supplies.

The delay has come under intense criticism amid an explosion in teenage vaping, driven chiefly by devices like Juul, which resembles a flash drive.

Cigarette use at wave 3 was higher among prior e-cigarette users (20.5%) compared with youths with no prior tobacco use (3.8%). More e-cigarette users, however, reported increased throat and mouth irritation (65.3%,) than nicotine replacement users (51.2%). "One reason is that there are over 400 brands of e-cigarettes and they vary substantially".

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