In recent years, electronic cigarettes (“e-cigarettes”) have emerged as a new option for individuals who wish to quit smoking. Progressive decreases in the concentration of nicotine allow users to wean themselves off their dependence, making this technique more adaptive than the nicotine patch or gum, for example. A new study from various institutions in the United Kingdom suggests that e-cigarettes may be nearly twice as effective as conventional means in aiding smoking cessation.

The study examined the smoking habits of 886 participants randomly divided into two groups over the course of a year. One group was provided with up to three months of conventional nicotine replacement products of their choosing, as is standard for the UK National Health Service’s stop-smoking service. The other group was given an e-cigarette and one bottle of e-liquid with a nicotine concentration of 18 milligrams per milliliter. Additionally, both groups were provided weekly one-on-one sessions with clinicians for at least four weeks. In each session, the participants’ breath carbon monoxide levels were measured to validate abstinence from smoking, and at the 4-, 26-, and 52-week time points, data were obtained regarding abstinence from smoking along with other markers of health. The one-year abstinence rate was 18% for the e-cigarette group and 9.9% for the nicotine-replacement group. A larger percentage of individuals who were not completely abstinent but reduced their smoking habits by at least half belonged to the e-cigarette group as well. E-cigarette participants reported higher satisfaction and less severe adverse symptoms such as irritability or restlessness, and a larger reduction in respiratory symptoms.

While this study is promising for the future of e-cigarettes in smoking cessation, the results must be considered in a larger context. This study provided in-person support and financial compensation, which may not always be available for those who wish to quit. The investigators also did not explicitly encourage users to reduce their nicotine dosage over the year of the study, hence these results cannot confirm whether e-cigarettes are better for breaking this factor of the addiction. Additionally, more e-cigarette users reported throat or mouth irritation at the one-year time point. A recent study from the Harvard T.H. Chan School of Public Health found that two chemicals commonly used to flavor e-cigarettes damage the lining of the lungs, suggesting that these devices may lead to worse adverse effects at longer time periods. Clearly, more investigation is necessary to properly weight the merits and drawbacks of e-cigarettes.

Managing Correspondent: Andrew T. Sullivan

Press Articles: “E-Cigarettes Are Effective at Helping Smokers Quit, a Study Says,” The New York Times

“Controversy over e-cigarette flavorings heats up,” The Harvard Gazette

Original Journal Articles: A Randomized Trial of E-Cigarettes versus Nicotine-Replacement Therapy, New England Journal of Medicine

Transcriptomic response of primary human airway epithelial cells to flavoring chemicals in electronic cigarettes, Scientific Reports

Image Credit: Pixabay