E-cigarettes may help smokers quit after all

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With the rising popularity of e-cigarettes, the debate over whether these devices are a legitimate aid to smoking cessation -- or just another way for people to get hooked on nicotine -- has raged in recent years.

Now, a new study suggesting that e-cigarettes may, indeed, help smokers stub out their habit may spark further discussion.

E-cigarettes are electronic devices that allow users to inhale flavored vapor that typically contains nicotine. The use of e-cigarettes, also called “vaping,” has boomed in the United States in recent years and they are now used by over 9 million Americans. The new study, published in the BMJ, a medical journal, stands in contrast to previous studies suggesting that using e-cigarettes actually make it harder to quit.

In the new study, researchers looked at data on the smoking habits of more than 160,000 Americans, taking particular note of whether these smokers reported using e-cigarettes or not. They found that 65 percent of smokers who used e-cigarettes attempted to quit, while only 40 percent of those not using the devices tried to quit smoking. The study also found that around 8 percent of smokers who used e-cigarettes who tried to quit were successful, compared to only around 5 percent of nonusers.

The study further suggests that e-cigarettes, rather than other factors like higher taxes or anti-tobacco campaigns, were responsible for the increased rate of quitting.

“We need to continue to monitor the impact; we don’t know what the safety level is of long-term e-cigarette use,” said Dr. Shu-Hong Zhu, lead author of the study and a professor of family medicine and public health at the University of California, San Diego. But, he added, the findings strengthen the case for the potential benefits of these devices for smokers trying to quit.

“We are pretty confident that e-cigarettes are less dangerous, but that is only because cigarettes are so bad,” he said.

But while the risks of e-cigarettes are still somewhat unclear, some public health experts say the results are promising.

“The rate at which people have made a quit attempt or successfully quit smoking has stagnated for many years,” said Dr. Kurt Ribisl, a professor at the University of North Carolina and a former member of the FDA’s Tobacco Products Scientific Advisory Committee. “For the first time in a long time, we are seeing more people quitting.”

Still, other experts in the field regarded these new findings with caution.

“E-cigarettes have not been demonstrated to be effective as a smoking cessation device and the overall evidence is that it makes it harder to quit,” said Dr. Stanton Glantz, a tobacco control expert at the University of California, San Francisco.

Glantz, in fact, previously authored a study finding that e-cigarettes may actually stymie efforts to quit smoking. But despite this, he said the findings of the new study warrant consideration -- a viewpoint shared by others in the field as well.

“The people who say that use of e-cigarettes inhibits cessation should be sobered by this paper,” said Dr. Steven Schroeder, a physician and tobacco researcher also at UCSF. “They should think twice about this viewpoint.”

But while this research suggests a link between e-cigarettes and quitting smoking, it will not be changing what doctors advise their patients -- at least not yet. The current guidelines for electronic cigarettes from the American Heart Association (AHA) recommend starting with FDA-approved therapies such as nicotine replacement and cessation counseling, which past research has shown to be effective.

The AHA also says that it is reasonable for physicians to support a patient’s use of an e-cigarette to stop smoking if they have failed approved therapies and would like to try this approach -- a far cry from doctors prescribing the devices to patients.

Will Garneau, M.D., is an internal medicine resident at the Johns Hopkins Hospital.