February 21, 2019
By Kate Wolin
Chief Science Officer
Results from a recent clinical trial UK for smoking cessation published in The New England Journal of Medicine showed that those who used e-cigarettes to stop smoking had nearly twice the quit rate at one year (18% vs 9.9%) than those using nicotine replacement therapy (NRT).
Unfortunately, while the results are encouraging, the story isn’t so simple. There are a couple things you find when you read past the headline.
In this clinical trial, both e-cigarette and NRT users received behavioral support for cessation. However, of those who had quit (and stayed quit) at one year, 80% of e-cigarette users were still vaping, while only 9% of the NRT users were still using NRT. The e-cigarette users were also more likely to report mouth and throat irritation. In fact, a Harvard study was released the same week as the clinical trial results and showed that the chemicals used to flavor e-cigarettes have compounds that impair cilia function. (Cilia are the antennae-like lining of your airways that allow you to breathe without irritation).
While there is promise for e-cigarette in smoking cessation, the US Surgeon General has warned that e-cigarettes may serve as a gateway to a smoking uptake in youth—the opposite of the effect shown in adults in the UK trial.
E-cigarettes appear to have benefits for smoking cessation in adults, but their use by youth gives us pause. While e-cigarettes do less harm to adults than cigarettes, some adults may be trading one addiction for another when using them as a smoking cessation tool. Both e-cigarettes and NRT can be part of a comprehensive smoking cessation program that includes behavioral support.
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