Does vaping help smokers quit more than gums and patches?

By Stephen Beech

Vaping really does help more people quit smoking than other methods, reveals new research.

Nicotine e-cigarettes are more effective in helping people stub out the habit than nicotine gums or patches and quitting with behavioral support or no support at all, according to the findings.

World Health Organization (WHO) figures show that smoking is the leading cause of preventable disease — resulting in more than 7 million deaths per year, including 1.6 million non-smokers who are exposed to secondhand smoke.

The new study, part of an ongoing living systematic review that is updated as new evidence becomes available, examined 80 controlled trials involving 29,861 participants.

The findings, published in the journal Cochrane Database of Systematic Reviews, showed that nicotine e-cigarettes led to higher quit rates than nicotine replacement therapy (NRT), such as patches and gum, resulting in about four more quitters per 100 people.

Nicotine e-cigarettes also outperformed non-nicotine cigarettes, resulting in about two more quitters per 100.

Compared to no support or behavioral support — such as individual counseling and group programs — quit rates were still higher when people were also provided e-cigarettes.

Study senior author Jamie Hartmann-Boyce said: "We have very strong evidence that regulated nicotine e-cigarettes are substantially less harmful than smoking.

"Based on the consistency of the findings here, it's clear that they are a proven and viable option for people wishing to quit traditional cigarettes.

"This update includes nine new trials and our main conclusions haven't changed."

The review found no evidence of increased serious harm from using e-cigarettes to quit, although researchers say longer-term studies are still needed.

The findings also apply specifically to regulated, nicotine-containing e-cigarettes; illicit products or those containing other substances, such as THC, may carry different risks.

Hartmann-Boyce, from the University of Massachusetts, said: "It's worth highlighting that our review looks at regulated e-cigarettes containing nicotine, but many of those available on the market do not meet these standards.

"Unlicensed e-cigarettes are potentially dangerous, with issues including unstable batteries and harmful chemicals.

"Anyone looking to use e-cigarettes to quit smoking should only purchase devices that have been tested and approved by their country's regulatory body.

"Lists of regulated devices are available from the FDA in the US and MHRA in the UK."

Many major health organizations, including the WHO, warn that vapes still expose users to nicotine and other chemicals which can be harmful.

There are also concerns that e-cigarette use by children and youth can lead to nicotine addictions and smoking tobacco products.

The research team cautioned that e-cigarettes aren't necessarily the best way for everyone looking to quit smoking, and that people should contact stop smoking support services or their doctors for guidance.

Vaping also comes with health risks, but, the researchers say, those risks "pale" in comparison to the dangers of smoking.

Review lead author Nicola Lindson, from the University of Oxford, said: "Quitting smoking is hard and a lot of people who smoke will have tried many times to quit smoking and been unsuccessful.

"For that reason, it is important that there are a number of different options available to help somebody quit, which could encourage them to keep trying.

"Although nicotine vapes are unlikely to be completely risk free, they are less harmful than smoking and that is the most important comparison to make for people who are still smoking tobacco."

Hartmann-Boyce sees the switch as a transition rather than an endpoint.

She said: "For somebody who is already addicted to nicotine through cigarettes, having a safer alternative like an e-cigarette is something worth considering, especially when other quit aids have proven unsuccessful."

Hartmann-Boyce added: "We are currently working on a review of interventions to help people quit vaping, which could be the next step along for people looking to transition to a lower-harm product before quitting nicotine altogether."