A small randomized controlled trial shows impressive effects of e-cigarettes on smoking cessation

Monday, 03 November 2014 11:10

A small randomized controlled trial shows impressive effects of e-cigarettes on smoking cessation

By Dr Farsalinos

A randomized controlled trial evaluating e-cigarettes effectiveness in reducing cigarette consumption and quitting smoking was published in International Journal of Environmental Research and Public Health. The study, led by Prof Frank Baeyens from the University of Leuven-Belgium, evaluated the efficacy of e-cigarette use in reducing smoking craving (in a laboratory session) and subsequently the 5-month smoking reduction or cessation rate in 48 participants (smokers who had NO intention to quit smoking). A control group of smokers not using an e-cigarette was included; they were given an e-cigarette 2 months after study initiation.

The study used second-generation devices (eGo-style batteries) and 18mg/ml nicotine concentration. During the laboratory conditions, researchers observed that smoking craving was suppressed after e-cigarette use at a similar rate to that observed after smoking tobacco cigarettes. After 2 months they observed a remarkable 34% quit rate in the group using e-cigarettes vs. 0% quit rate in the control group. At 5 months, the e-cigarette group had a quit rate of 37%, while the control group (which was given the e-cigarette for 3 months) had a quit rate of 38% (from 0% before they were given the e-cigarette). After the 5 months-time, no liquids were provided to the participants by the researchers, but they were advised to continue using e-cigarettes. At 8 months, the respective quit rates were 19% and 25%, with a smoking reduction of 60% in all groups. It must be emphasized that there was a very important reason for the reduction in quit rate: in Belgium it is forbidden to sell nicotine-containing liquids, thus, the only source is through the internet.

The study is important for 2 reasons:

1.      It shows that, even in smokers with no intention to quit, e-cigarettes are very effective smoking substitutes.

2.      It shows that restrictions in availability of nicotine-containing liquids can have devastating effects by causing a relapse back to smoking or by preventing smokers from using effective e-cigarette products.

Both messages should be seriously considered by regulators. At last, they must understand their ethical obligation to promote the interest and health of smokers. Any decision against that, and any regulations restricting availability, should make them accountable for the adverse health effects expected in smokers who relapse back to smoking, in smokers who are discouraged from switching to a less harmful alternative, and in smokers who are deceived into thinking that e-cigarettes are equally harmful to tobacco cigarettes.