E-cigarettes are twice as effective as nicotine substitutes !

Introduction

The question has been on many lips for a while now : are e-cigarettes really effective when trying to quit smoking ? A recent scientific study finally provides a clear and encouraging answer !

Presentation

No scientific study had been able to decide since the introduction of e-cigarettes on the market. Each made useful contributions, but none offered a concrete answer. Indeed, there were often gaps in the method and sometimes very heterogeneous results.

A study was published in late January 2019 in the New England Journal of Medicine showing the effectiveness of e-cigarettes in trying to quit smoking. This study stands out from the previous ones by the quality of its methodology. Here’s why :

Methodology

All participants were individuals who used the English Smoking Cessation Assistance Service, the U.K. National Health Service stop-smoking. They had the choice between nicotine substitutes, including a combination of products or a second-generation e-cigarette pack for beginner with an e-liquid dosed with 18mg/ml of nicotine. The instruction was to supply themselves in the future with e-liquids in the flavour and nicotine level of their choice. The assistance included weekly follow-ups for 4 weeks.
The first results were established following a 1-year abstinence, all confirmed by tests. Participants who did not attend the follow-ups or refused the tests were considered non-abstinent.
The second results included the treatment used and respiratory symptoms.

Results

The results take in consideration 886 participants. At the end of the first year, 18% of people who used e-cigarettes were abstinent, compared to 9.9% in the nicotine substitutes group.
People who used e-cigarettes were more likely to use the product during the 52 weeks - 80%, 63 out of 79 versus 9%, or 4 out of 44.
Irritation of the throat and tongue was reported more frequently in the e-cigarette group, 65.3% versus 51.2% in the substitutes group, while nausea was reported more frequently in the substitutes group, 37.9% compared to 31.3% in the e-cigarette group.

The e-cigarette group reported a faster decrease in coughing and mucus production than the substitutes group. No significant differences were found in both groups in terms of hissing in the breathing or shortness of breath.

Conclusion

E-cigarettes were more effective to quit smoking than nicotine substitutes, when both types of therapies were followed with behavioural support.

Statement by Professor Jean-François Etter

Professor Jean-François Etter, founder of stop-tobacco and professor at UNIGE, gave his statement about the study. On the issue "Will nicotine substitutes or e-cigarettes be offered to a patient who wants to quit smoking ?” Professor Etter replied that there would be two approaches :

• The first would be to offer help using the available substitutes allowed and to use e-cigarettes in case of failure, but so few people use nicotine substitutes it would greatly reduce the pool of smokers who would then use e-cigarettes.
• The second approach would be to tell smokers to use e-cigarettes or any other way of consuming nicotine without combustion. Since it has now been shown to be effective with quitting and is significantly less risky than smoking. Give up combustion immediately to use another form of nicotine or tobacco, or preferably try to do without it all together. But if one cannot stop, then favour at all costs a form without combustion.

To the question « We have little hindsight on e-cigarettes and even if there is no combustion, there are still aromas and other substances, so is it still healthier ? » Professor Etter clearly replies "yes." Experts agree, not on the amount of the risk reduction, but on the fact that it is less risky, so it is a risk reduction strategy, similar to illicit drugs where we’ve had this strategy for years. These are no risk-free products, but they are still much less risky than combustion products, which are now obsolete products that consumers have to give up and use vaping products or any other tobacco products without combustion, if they can’t stop.

To the question « That’s to say, in the future, we could refund e-cigarettes ? » Professor Etter replies that at this time none of these products are registered and sold as medicine. In England, an e-cigarette has been registered as medicine, but is not on the market. But it could come, we could imagine a future where some of these vaping products will be registered as medicine, possibly reimbursed or not, and others, will be recreational, non-medical products.

Find his interview here in the 12:45 from 31.01.2019 on the RTS.

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