Trying to quit smoking? Or at least thinking about trying to quit?
According to a new study published today in the New England Journal of Medicine, you may have more success with e-cigarettes than a nicotine patch or gum.
Clinical trials involving nearly 900 smokers in the UK found that 18% of e-cigarette users were non-smokers after a year, compared with 9.9% of people using nicotine replacement products, such as patches, rubbers, lozenges and aerosols.
Leading researcher Peter Hajek, from the Queen of Mary's University of London, said that although e-cigarettes were commonly used in attempts to stop smoking, there was not much evidence that they actually helped.
During the trial, the participants received either a three-month nicotine replacement (or combination of products) or an e-cigarette pack with one or two bottles of e-liquid and encouraged to buy future supplies.
For at least four weeks, the trial participants also received weekly individual behavior.
For those who are successful, 80% of e-cigarette users were still empty after one year, but only 9% of those with nicotine replacement products still used them.
The co-author of the study, Hayden McRobbie, said, although the long-term vapor risk is unknown: t [was] highest risk ”.
"We want to see a smoker switch [to vaping]and then they're getting out of the way, ”said Professor McRobbie, Professor of Public Health Intervention at Queen Mary University, London.
"But for people who don't smoke, we don't want them to start steam."
More efficient than quitting cold turkey
Coral Gartner, head of the Nicotine and Tobacco Control Research Group at Queensland University, said the findings provided "high-level evidence" of using e-cigarettes as a way to quit smoking.
"This research provides quite good support [e-cigarettes] is an approach we could use in clinical practice, ”said Dr Gartner, who was not involved in the study.
She said that the study's payback rates – 18 percent for e-cigarettes and 9.9 for nicotine replacement therapy – were significantly higher than the average "cold turkey" success rate.
"So, I see that the yield of e-cigarettes – 18 percent – is very good, because the level of success of the withdrawal is low."
According to the researchers, the "stronger impact" of the e-cigarettes found in the study (compared to previous trials) could be related to the inclusion of smokers who were actively seeking help, providing direct support, and using modern refillable e-cigarettes.
"It wasn't," Here's an e-cigarette, good luck! "- People were supported by behavioral support," said Professor McRobbie.
"The participants were addicted smokers, but they were also people who wanted to quit.
"I think the study shows that e-cigarettes can help you stop smoking, but they are not a magic cure … there are other things to do to make this trip easier."
As to why it was found that e-cigarettes were more effective than other nicotine replacement products, the researchers suggested allowing people to better adjust their nicotine dosage and provided some familiar smoking methods.
"E-cigarettes were more effective in relieving the symptoms of tobacco withdrawal … and were rated as helpful in preventing smoking than nicotine replacement products," they wrote.
According to this study, further research was needed to determine whether outcomes could be generalized outside the UK cessation of smoking services.
Concern about long-term use
Although abstinence rates at all points in the study were higher among e-cigarette users, the rate of continuous use of steam at the end of 12 months was "fairly high" – eight out of 10 users were still empty.
"It can be considered problematic if the use of e-cigarettes for a year illustrates long-lasting use, which can cause unknown health risks," writes the authors.
This is one of the main concerns of Australian public health experts: that there is not enough evidence yet to prove that vapors are safe, especially in the long term.
Professor Simon Chapman, a public health emeritus from the University of Sydney, recently said at ABC: "It will take decades before we know if steaming is less dangerous than smoking and how much, if at all."
The recent CSIRO report found that regular use of e-cigarettes is likely to lead to 'adverse consequences for health', but the report also states that 'there is a lack of clarity about the adverse health effects and the amount of e-cigarettes needed to trigger [them]".
According to Dr Gartner, there must be a "trade break": take e-cigarettes for a longer period to achieve "greater success".
"Obviously, the safest option will not be smoking or steaming, but if someone tries to quit smoking, it can take them for many years … and the steam can help them stop and reduce the risk.
"It's about harm reduction – helping people move around the risk continuum to a lower risk."
Dr Gartner said it was important that the people who smoked and steamed together went to the steam only and, when they could, stopped completely.
"I would like to encourage people who use vaping – even as a way to stop smoking – to stop smoking eventually," she said.
She and Professor McRobbie said that part of the challenge was that more frequent and longer-term use of steam, as shown in the study, was an "important factor" for higher success rates for people who used it to leave.
"We know that long-term use of nicotine replacement therapy prevents relapse, and that is what we see here: vapors delayed relapse," Professor McRobbie said.
Dr. Gartner said that although vaping was a lower risk behavior, it was not without risk.
"It's a complex and complex area. It's easy to say," Stop: do nothing. "But the same with many health behaviors – it's hard," she said.
Push to reflect on regulation
More and more often Australia is in the field of e-cigarette regulation.
Vaping nicotine is legal in the UK, New Zealand, the United States, and Canada, but the sale of liquid nicotine in Australia is illegal – a ban approved by the Therapeutic Goods Administration (TGA) in 2017.
People who want nicotine in their e-cigarettes should order it in liquid form from abroad or receive a doctor's prescription. But very few doctors want to sign.
"Nicotine-containing e-cigarettes are not available to current Australian smokers because there is no product approved as smoking cessation aid," said Dr Gartner.
In Australia, all smoking cessation products should be officially assessed and approved by the TGA.
"Unless something has changed radically, at this stage it is essentially the end … there is not much interest in getting the product they have approved," said Dr Gartner.
She said that instead of regulating drugs, policymakers should "look very seriously at the different models", including the production of nicotine-containing e-cigarettes as a "highly regulated" consumer product with "many controls".
"We have now got the most harmful products – tobacco cigarettes – sold in supermarkets," she said.
"We have to ask: is this really appropriate, especially if there is another product that could replace them and be part of the risk?"
Professor McRobbie agreed that smokers' action was available but did [our] best suited to smokers only "was" perfect. "
"It's about balance," he said.
Public health experts have expressed concerns about the possible intake of steam among young people – and this will provide a gateway to tobacco smoking – if the regulation changes.
In September, the US Food and Drug Administration announced that it was considering banning aromatic e-cigarettes because the country was grabbed by an "e-cigarette" epidemic that threatens to create new-generation drug addicts.
Dr. said it was "definitely a concern" and some health care institution would have to "monitor very carefully".
"I don't think we should definitely assume that if we changed the way we regulated e-cigarettes, we would see how they saw the US," she said.
"But this is something we should look at and try to minimize."