The Importance of Considering E-Cigarettes as Harm Reduction Tools

A study published in The American Journal of Drug and Alcohol Abuse reiterates the need to embrace the use of e-cigarettes (ECs) as harm reduction tools.

Diane Caruana

September 16, 2022

Data from thousands of studies has indicated that smokers who turned to nicotine e-cigarettes were more likely to remain abstinent from smoking than those in the control condition.

Titled, “A targeted approach to using e-cigarettes for harm reduction in adults,” the paper highlights that the negative perceptions of ECs and widespread inaccurate belief that they are equal or more harmful than combustible cigarettes, represents a significant missed public health opportunity.

The paper outlines the need to overcome such perceptions and openly explore the potential use of EC as a harm-reduction strategy in smokers who otherwise find it really hard to quit. Supporting this argument, a recent 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.

ECs vs 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.