A new study based on real-world data from England lends support to the idea that electronic cigarettes can help smokers quit using regular cigarettes.
Among a sample of 5,963 adults who tried to kick the habit without prescription medications or counseling, those who turned to e-cigarettes were about 60% more likely to succeed than those who used nicotine replacement therapy or went cold turkey. Researchers from University College London published their results online Tuesday in the journal Addiction.
Electronic cigarettes are battery-powered devices that burn a nicotine solution to create a vapor resembling the smoke from a tobacco cigarette. Advocates say they promote health by providing an alternative to traditional cigarettes and the poisonous tars and carbon monoxide that come with them. Critics – including Dr. Tom Frieden, director of the Centers for Disease Control and Prevention – counter that e-cigarettes get people (especially kids) to get hooked on nicotine, increasing the risk that they will move on to regular cigarettes.
Scientists and public health officials are eager to sort out the pros and cons of e-cigarettes, which are lightly regulated and increasingly popular. Surveys and clinical trials designed to measure the effectiveness of e-cigarettes as a smoking cessation tool have produced mixed results.
For the new study, researchers turned to data from the Smoking Toolkit Study, an ongoing survey of English smokers. They examined survey responses gathered between July 2009 (when e-cigarettes were relatively new) and February 2014 from smokers who said they tried to quit at least once in the previous year. For the sake of simplicity, they focused on three groups of would-be quitters: Those who used only e-cigarettes (8% of the sample); those who used only non-prescription nicotine replacement items like gum or patches (33% of the sample); and those who didn’t use any kind of smoking cessation treatment (59% of the sample).
The raw data were strongly in favor of e-cigarettes, with 20% of those who used them saying that they had quit smoking. That compared with 10% of those who used non-prescription nicotine replacement therapy and 15% of those who went cold turkey.
But the people who opted for electronic cigarettes were not the same as other smokers, so the researchers controlled for factors like age, gender, socioeconomic status and the degree of their nicotine dependence. With these factors taken into account, the researchers found that people who used electronic cigarettes were 1.63 times more likely to to quit smoking than those who opted for nicotine replacement therapy. In addition, they were 1.61 times more likely to succeed than people who didn’t use any smoking cessation aids.
The study participants did not have to verify their nonsmoking status by taking a urine test or anything else, the researchers noted. But they said that given the survey’s design, people would have had little incentive to lie.
The findings provide reliable information on the value of e-cigarettes “in the real world,” the study authors concluded.
“E-cigarettes may prove to be both an efficacious and effective aid to smoking cessation,” they wrote. “Insofar that this is true, e-cigarettes may substantially improve public health because of their widespread appeal and the huge health gains associated with stopping smoking.”
The study was funded in part by Pfizer, which makes the smoking cessation drug varenicline (sold under the trade names Chantix and Champix). In addition, four of the five researchers disclosed that they had received grants and other fees from “companies that develop and manufacture smoking cessation medications.” None of the five has a financial relationship with a company that makes electronic cigarettes.
Senior author Robert West, a professor of health psychology and director of tobacco studies at University College London, is the editor in chief of Addiction.