E-cigarettes facilitated quitting as well as patches

Electronic cigarettes, both with and without nicotine, helped smokers quit about as well as nicotine patches did, a recent New Zealand study found.

A total of 657 adult smokers who wanted to quit were randomized in 4:4:1 ratio to e-cigarettes with 16 mg of nicotine, a daily 21-mg nicotine patch or placebo e-cigarettes with no nicotine, from one week before quit day to 12 weeks after. They were also offered access to telephone support thorough the national quitline, and smoking abstinence at six months was verified by exhaled breath carbon monoxide measurement. The controlled trial, which was funded by the Health Research Council of New Zealand, ran from September 2011 to July 2013. Results were published online by The Lancet Sept. 7.

At six months, abstinence rates were insignificantly different among the groups, at 7.3% in nicotine e-cigarette users, 5.8% in patch users and 4.1% in placebo e-cigarette users. Overall cessation rates were substantially lower than the researchers had expected, so the study was underpowered to detect a difference between the quitting aids. There were no significant differences between groups in adverse events, either.

The study authors concluded that e-cigarettes were modestly effective and might be as effective as nicotine patches for achieving cessation. One strength of the study was its real-world setting, but a limitation was the use of first-generation e-cigarettes, which delivered less nicotine than promised by their labeling. The authors called for research into second-generation e-cigarettes and the effects of longer-term use.

An accompanying comment noted that the e-cigarettes also appeared to have helped study participants who didn't cease smoking reduce their tobacco cigarette consumption and that, as a replacement for tobacco cigarettes, e-cigarettes could “ultimately lead to the disappearance of combustible tobacco products and to the end of the epidemic of smoking-related disease and death.” Based on this study, “health professionals will now hopefully feel easier about recommending e-cigarettes to smokers, or at least condoning their use,” the commenter concluded.