Science

E-cigs “almost twice as effective as NRT” says new study

A new randomised trial of vapour products – the gold standard in scientific testing – has spectacularly demonstrated the effectiveness of e-cigarettes as a way to quit smoking. The study, carried out by a team from London’s Queen Mary University and supported by the National Institute for Health Research, Health Technology Assessment Programme and Cancer Research UK, followed nearly 900 smokers through their quit attempt and looked at any symptoms they experienced as well as their success at quitting.

Fergus Mason

February 1, 2019

The study was a simple one. A total of 886 participants – all adults attending National Health Service smoking cessation clinics – were randomly divided into two groups. Members of one group were given a conventional Nicotine Replacement Therapy of their choice (including combinations of products if they wanted it) while the other group were given a second-generation e-cigarette, a bottle of 18mg/ml liquid and advice on buying more juice. Both groups were also offered behavioural support.

The e-cigarette group were almost twice as successful, with an abstinence rate of 18%

After one year the participants were assessed for smoking status, including biochemical tests to ensure that those who claimed to have quit smoking really had. The NRT group had a 9.9% abstinence rate at one year – surprisingly high, as previous studies have found NRT to be only 5-7% effective. However, the e-cigarette group were almost twice as successful, with an abstinence rate of 18%.

Does sustained use help?

One big difference between the two groups was how many people continued to use their quit aid at the one-year point. In the NRT group, 4% of successful quitters were still using their chosen product after twelve months. In sharp contrast, 80% in the e-cigarette group were still using theirs. It seems likely that using a more enjoyable product makes people more likely to stick with it, and thus less likely to relapse to smoking.

There were also differences in the symptoms reported between the two groups. The e-cig users were more likely to report throat and mouth irritation, while the NRT group were more likely to suffer from nausea. This difference is likely to be a simple effect of the nicotine delivery routes. Meanwhile the e-cigarette group showed a larger decline in coughs and sputum production – surprising, as these are respiratory symptoms.

The study only had one real weakness – the use of second-generation vapour products. These are eGo-style devices, simple and reasonably effective but a long way behind what’s on the market now. That probably explains the fact that vaping was only twice as effective as NRT; with modern products it would likely be significantly higher.