E-cigarettes dramatically boost smokers’ chances of successfully quitting, according to recent research.
Professor Robert West, Ph.D., of University College London, UK, said, “E-cigarettes could substantially improve public health because of their widespread appeal and the huge health gains associated with stopping smoking.”
The deaths and disease caused by cigarette smoking comes mainly from breathing in toxins other than nicotine in the smoke. Electronic cigarettes, or e-cigarettes, provide a heated vapor containing nicotine without tobacco combustion. They seem to reduce cigarette cravings and withdrawal symptoms, while being much safer than ordinary cigarettes.
Research suggests they are better at helping smokers cut down or stop than nicotine replacement therapy, as they more closely mimic the sensory experience of cigarettes.
Writing in the journal Addiction, West reported on his study of 5,863 smokers surveyed between 2009 and 2014.
All were attempting to quit without using prescription medication or professional help. The survey showed that 20 percent of those using e-cigarettes had stopped smoking conventional cigarettes, a 60 percent improvement compared to those using nicotine replacement therapies such as patches or gum, or will power alone.
The benefit of e-cigarettes remained when many other factors were taken into account, including age, level of nicotine dependence, previous attempts to quit, and whether quitting was gradual or abrupt.
“It is not clear whether long-term use of e-cigarettes carries health risks but from what is known about the contents of the vapor these will be much less than from smoking,” said West.
“Some public health experts have expressed concern that widespread use of e-cigarettes could ‘re-normalize’ smoking. However, we are tracking this very closely and see no evidence of it. Smoking rates are declining, quitting rates are increasing and regular e-cigarette use among never-smokers is negligible.”
Co-author Jamie Brown, Ph.D., also of University College, said, “We will continue to monitor success rates in people using e-cigarettes to stop smoking to see whether there are improvements as the devices become more advanced.”
The team also carried out another survey of 3,538 current and 579 recent ex-smokers. This found that most people using e-cigarettes are choosing first generation “cigalike” products, rather than the more recent ones that have refillable cartridges and a range of nicotine concentrations and flavors.
This survey showed that 93 percent of respondents were aware of e-cigarettes. About a fifth were currently using e-cigarettes, and just over a third had previously used them. Most (67 percent) believed e-cigarettes to be less harmful than cigarettes.
“There is a near universal awareness of e-cigarettes and their use appears to be common among smokers, although a quarter of all smokers are unsure as to whether e-cigarettes are less harmful than cigarettes,” report the researchers.
“E-cigarette users appear to have higher socioeconomic status, to smoke more cigarettes per day and to have attempted to quit in the past year,” they add.
Public health expert Dr. John Britton of Nottingham University noted that e-cigarettes “are now providing clear proof of the concept that, if offered attractive, socially acceptable and affordable alternatives to tobacco, large numbers of smokers will use them.”
In the U.S., the market has recently been estimated to be worth $1.85 billion a year.
But “quality and performance data remain scarce,” he warned.
“This lack of information on quality, the lack of controls on marketing and use, their rapid uptake in society and the growing involvement of the transnational tobacco companies in this market have caused considerable concern, particularly in the health professions, about the place of these products in public health.”
Nevertheless, any hazard posed by the nicotine vapour from e-cigarettes “is evidently minimal in relation to that arising from inhaling tobacco smoke,” Britton said. He pointed out that “long-term use of nicotine from e-cigarettes is likely to have even less impact on health and life expectancy that that of low-nitrosamine smokeless tobacco” (such as chewing tobacco).
So, while the ideal is an end to all nicotine use, “the reality is that for as long as people smoke, it is unethical, illogical, paternalist and damaging to both individual and public health to deny access to reduced-hazard products such as e-cigarettes.”
The current lack of regulation of e-cigarettes is a worry, but at least it reduces the barriers and costs to product development and innovation, and freedom to advertise maximises exposure across the smoking population, Britton said. On the other hand, there is no guarantee that products deliver nicotine reliably, or without unnecessary and potentially hazardous components or contaminants.
In April 2014, the U.S. Food and Drug Administration (FDA) issued a proposed “deeming rule,” which would regulate e-cigarettes as tobacco products. If it is adopted, the rule would extend the FDA’s regulatory authority over e-cigarettes, making them subject to the laws on sales to minors and warning labels. But until the rule is adopted, the FDA’s Center for Tobacco Products has no authority to regulate the sale or use of e-cigarettes.
Brown, J. et al. Real-world effectiveness of e-cigarettes when used to aid smoking cessation: a cross-sectional population study. Addiction, 21 May 2014 doi: 10.1002/14651858.CD008286.pub2
Brown, J. et al. Prevalence and characteristics of e-cigarette users in Great Britain: Findings from a general population survey of smokers. Addictive Behaviors, 11 March 2014 doi:/10.1016/j.addbeh.2014.03.009