E-cigarettes as smoking-cessation devices? Study adds to skepticism

March 24, 2014 | by Nicole White

E-cigarettes have ignited plenty of debate recently, especially as cities have begun to ban public use of the devices, just as they've done with traditional cigarettes. Although users say e-cigarettes, or e-cigs, can help smokers quit, evidence that the devices are effective has been unconvincing – and a new study has failed to come to their defense.

The study, published today in the Journal of the American Medical Association, confirms the suspicions of many experts that e-cigarettes are not associated with greater rates of quitting cigarettes or even cutting back on smoking. The study found that women, younger adults and people with less education are more likely to use e-cigarettes and that, based on self-reported data after a year of use, the devices are not associated with quitting or even with a change in cigarette consumption.

“They try to market e-cigarettes as alternatives, but they are nicotine-delivery devices,” said Brian Tiep, M.D., director of pulmonary rehabilitation and smoking cessation at City of Hope. “We don’t know what else they’re bringing into our bodies. When cigarettes were first presented as a product that should be legal, everyone believed they were harmless. Given our present knowledge, if they were introduced for the first time now, we would say, 'Of course these should not be legal products.' Now we have an ‘alternative’ that has at least one of the same ingredients – and that’s the ingredient they get addicted to, nicotine.”

The JAMA study was conducted by researchers at the University of California, San Francisco. The team analyzed self-reported data from 949 smokers to determine if e-cigarettes were associated with successful attempts to quit smoking or with reduced cigarette consumption. At the start of the study, only 88 of the smokers used e-cigarettes, and the authors of the study acknowledge that the low numbers of e-cigarette users participating may limit their ability to detect an association between e-cigarette use and quitting.

“Nonetheless, our data add to the current evidence that e-cigarettes may not increase rates of smoking cessation,” the paper states. “Regulators should prohibit advertising claiming or suggesting that e-cigarettes are effective smoking-cessation devices until claims are supported by scientific evidence.”

Tiep said he agrees that both regulators and consumers should be aware that e-cigarettes should not be embraced as quitting devices until scientific studies support that notion.

“It is important to note that e-cigarettes are being sold by the tobacco industry with the implication that they are quitting devices – but they are not calling them a medication for quitting because they would be regulated by the Food and Drug Administration,” Tiep said. “They don’t want that. They also don’t want them to be regulated as cigarettes.”

They are frequently promoted as a safer alternative to smoking cigarettes, but their safety is largely untested. Further, because the devices are not regulated by the Food and Drug Administration, the manufacturers of e-cigarettes are not required to list the ingredients in the products.

“While they probably are safer – we really don’t know for sure – there are still secondhand smoke issues to consider, as the vapor they emit can contain nicotine,” Tiep said.

Tiep is also troubled that e-cigarettes seems to be appealing to children and teenagers. A recent study from the Centers for Disease Control and Prevention found that, from 2011 to 2012, e-cigarette use among middle and high school students nearly doubled.

If the goal of e-cigarette users is to quit smoking, Tiep says, they should use smoking-cessation methods and aids that have been scientifically proven to work.


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