The effectiveness of electronic cigarettes in smoking cessation

A recent study published in Tobacco Control suggests that e-cigarettes may not be more effective than other cessation methods for quitting smoking. However, the authors note limitations to their study.

Data from randomized clinical trials tend to show that e-cigarettes could help smokers quit smoking. However, real-world studies are now much more equivocal about the degree of effectiveness of these new products, including those with higher nicotine concentrations.[1].

The study is based on data from the Population Assessment of Tobacco and Health (PATH) collected in the United States between 2017 and 2019, based on 3,578 smokers who had recently tried to quit and 1,323 recent former smokers. Respondents were asked to provide the method by which they had tried or succeeded in quitting (e-cigarettes, traditional nicotine replacement products, pharmaceutical products), the nicotine concentration at which e-cigarette users set their device, as well as health and sociodemographic information (income level, education, ethnicity, level of smoking, age of onset of regular smoking, etc.).

Successful abstinence lower among e-cigarette users

The researchers then sought to assess, based on the respondents' last attempt to quit, the rate of smoking abstinence over twelve months, depending on the methods used. The study reports that smokers who tried to quit smoking using e-cigarettes had a successful smoking abstinence rate of 9.9%, which is lower than the observations made among smokers who used nicotine replacement products (15.2%), or those who did not use any product in this process (18.6%). Furthermore, the study notes that smokers who switched to e-cigarettes had a higher rate of smoking relapse than others. However, the authors of the study qualify these results by arguing that the observed differences are not statistically significant.

The need for further research to be carried out

However, while the results tend to show the lower effectiveness of e-cigarettes in smoking cessation compared to nicotine replacement products, the study has certain limitations. First, it is possible that certain unidentified variables could affect the reliability of the results. Furthermore, the researchers emphasize that the influence of nicotine concentration levels in e-cigarettes is currently unknown, and should lead to further research. A review of the scientific literature published at the end of 2021 suggested that while e-cigarettes could probably be an aid for smokers in the first six months of abstinence, additional research should be conducted to understand the effectiveness of new generations of e-cigarettes, which deliver nicotine better than previous models.[2].

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[1] Chen R, Pierce JP, Leas EC, et al, Effectiveness of e-cigarettes as aids for smoking cessation: evidence from the PATH Study cohort, 2017–2019, Tobacco Control Published Online First: 07 February 2022. doi: 10.1136/tobaccocontrol-2021-056901

[2] Hartmann-Boyce J, McRobbieH, ButlerAR, LindsonN, BullenC, BeghR, TheodoulouA, NotleyC, RigottiNA, TurnerT, FanshaweTR, HajekP.Electronic cigarettes for smoking cessation. Cochrane Database of Systematic Reviews 2021, Issue 9. Art. No.: CD010216. DOI: 10.1002/14651858.CD010216.pub6.