May 23, 2014 | by Denise Heady
Electronic cigarettes, or e-cigs, can indeed help smokers kick their tobacco cigarette habit, new research suggests, bolstering supporters' claims that the devices can be beneficial. The research is generating considerable media attention, with headlines suggesting that e-cigarettes have been vindicated, but reaction from some smoking experts has been far more muted, even skeptical.
The new study, published in the journal Addiction this week, suggests that smokers who use e-cigarettes as a means to quit have up to a 60 percent better chance at succeeding than smokers who used a licensed nicotine replacement therapy product, such as a nicotine patch or gum, or smokers who used no aid at all.
Researchers analyzed data gathered from 2009 through 2014 on nearly 6,000 smokers who had made at least one attempt to quit smoking tobacco cigarettes in the past year.
Of those surveyed, 464 had used only e-cigarettes to try to quit, 1,922 had used only over-the-counter nicotine replacement, and 3,477 had attempted to quit without any aid.
The outcome was self-reported and adjusted for key potential confounders such as nicotine dependence. The researchers found that the quitting rate for participants who used e-cigarettes was 1.63 times higher than the rate for people who used nicotine replacement therapy and 1.61 times higher than the rate for people using no aid. The results sound impressive, but some experts find the study’s methods to be problematic.
City of Hope’s Brian Tiep, M.D., director of pulmonary rehabilitation and smoking cessation, said the study has some serious flaws that need to be reviewed. “It was not a randomized control study, rather a 'self-selection' study,” Tiep said. That type of research can tilt the findings, he pointed out, despite researchers' attempts to offer a clear-eyed assessment.
“The investigators made a careful effort to control for confounding variables," Tiep said. "I have little doubt that they made the findings that they reported. In their discussion, they reported on the limitations of their findings, and they were careful not to recommend e-cigarettes as a means to quit smoking.”
Tiep also noted that nicotine replacement therapy, when properly prescribed with appropriate dosing of nicotine, is about 20 percent effective in helping smokers quit. Effectiveness increases if patients receive behavioral support.
He also noted the conflicting research on e-cigarettes. Just two months ago, a study published in JAMA Internal Medicine reported that electronic cigarettes do not help people curb or quit smoking.
“Recent studies conclude that e-cigarettes are not safe products, albeit probably safer than tobacco cigarettes,” Tiep said. “As a physician, I will not recommend e-cigarettes as a safe method to quit smoking.”
With professionals reluctanct to embrace e-cigarettes, the debate about their effectiveness as a smoking cessation tool seems likely to continue.
So will the headlines.
Learn more about lung cancer treatment and research at City of Hope.