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 stopping smoking. However, the authors note limitations to their study.

Data from randomized clinical trials tend to show that e-cigarettes could be a support for smoking cessation for smokers. However, studies conducted in real conditions are now much more equivocal on the degree of effectiveness of these new products, including those with higher nicotine concentration levels.[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 information on the means 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 levels, education, ethnicity, level of smoking, age of entry into 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 substitutes (15.2%), or those who did not use any product in this process (18.6%). Furthermore, the study notes that smokers who turned to e-cigarette use had a higher rate of smoking relapse than others. However, the authors of the study qualify these results by arguing that the differences observed 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 some 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 not currently known, and should lead to additional 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.