The objective of the study was assessing the effectiveness of e-cigarettes for smoking cessation in the USA from 2017 to 2019. Whilst taking in consideration the dramatic increase in high nicotine e-cigarette sales in 2017.
The research team analyzed data from the PATH Cohort Study including data on 3578 previous year smokers with a recent quit attempt, and 1323 recent former smokers, whilst taking in consideration the use of e-cigarettes and other products as cessation aids.
The study concluded that the sales increases in high nicotine e-cigarettes in 2017 did not translate to more smokers using these e-cigarettes to quit smoking, and that vaping did not improve successful quitting or prevent relapse.
Discussing the study, Prof John Britton, Emeritus Professor of Epidemiology, University of Nottingham, said that the observational study is flawed. “The findings of this observational study of quitting and e-cigarette use in the USA are fundamentally flawed by confounding by severity, whereby the heaviest (most addicted) smokers, having tried and failed to quit using NRT or other treatments in the past, or who have declined to try to quit in the past, then try e-cigarettes.”
He highlighted that in fact the findings contradict those from many other peer reviewed studies. “This is probably why they conflict with the findings of meta-analyses of the multiple, well-designed clinical trials that have demonstrated that e-cigarettes are effective quitting aids, and which led to the UK National Institute for Health and Care Excellence (NICE) recommending e-cigarettes to help smokers to quit in guidance published at the end of 2021.”
Smokers using vapes were more likely to remain abstinent
In fact, a review of randomized controlled trials and network meta-analysis of e-cigarettes for smoking cessation, found that smokers assigned to use nicotine e-cigarettes were more likely to remain abstinent from smoking, than those assigned to using licensed NRTs.
Titled, “A systematic review of randomized controlled trials and network meta-analysis of e-cigarettes for smoking cessation,” the study compared the effectiveness of nicotine e-cigarettes for smoking cessation with licensed nicotine replacement therapies (NRT) and nicotine-free based control conditions.
The researchers searched PubMed, Web of Science and PsycINFO for randomised controlled trials (RCTs) that allocated individuals to use nicotine e-cigarettes, compared to those that used licensed NRT (e.g., nicotine patches, nicotine gums, etc), or a placebo. The research team selected only studies which included smoking participants who were healthy.
Sifting through data from thousands of studies, the research team identified that smokers who turned to nicotine e-cigarettes were more likely to remain abstinent from smoking than those in the control condition. “Smokers assigned to use nicotine e-cigarettes were more likely to remain abstinent from smoking than those assigned to use licensed NRT, and both were more effective than usual care or placebo conditions. More high quality studies are required to ascertain the effect of e-cigarette on smoking cessation due to risk of bias in the included studies,” concluded the study.
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