Are E-Cigarettes an Effective Smoking Cessation Therapy?

Supplemented by behavioral support, e-cigarettes are a more effective smoking cessation therapy than nicotine-replacement products, according to a new study.

To compare the therapies’ efficacies, the researchers randomly assigned 886 adults who were attending UK National Health Service smoking cessation services to either a nicotine-replacement product of the participants’ choice (n = 79) or an e-cigarette starter pack (n = 44).

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The nicotine-replacement product included product combinations and was provided for up to 3 months. The e-cigarette starter pack consisted of a second-generation refillable e-cigarette with 1 bottle of nicotine e-liquid (18 mg/mL). The researchers recommend that participants in the e-cigarette group purchase further e-liquids of the flavor and strength of their choice.

The cessation treatment also included at least 1 month of behavioral support.

The 1-year smoking abstinence rate was 18.0% in the e-cigarette group and 9.9% in the nicotine-replacement group.

After 1 year, participants who achieved abstinence in the e-cigarette group were more likely group to use their assigned product than those who achieved abstinence in the nicotine-replacement (80% vs. 9%).

And while throat or mouth irritation was reported more frequently in the e-cigarette group than in the nicotine-replacement group (65.3% vs 51.2%), reports of nausea were more common among the nicotine-replacement group than in the e-cigarette group (37.9%, vs 31.3%).

Participants who utilized e-cigarettes also experienced a decrease in cough and phlegm production in the first year after baseline compared with those who used nicotine-replacement products. However, there was no significant difference in the incidence of wheezing or shortness of breath between the 2 groups.

—Colleen Murphy

Reference:

Hajek P, Phillips-Waller A, Przulj D, et al. A randomized trial of e-cigarettes versus nicotine-replacement therapy [published online January 30, 2019]. N Engl J Med. doi:10.1056/NEJMoa1808779.