A UK trial found that e-cigarettes were almost twice as effective for quitting smoking as other nicotine replacement treatments.
The Queen Mary University of London trial, supported by Cancer Research UK, is the first to test how effective e-cigarettes and behavioural support are in combination as part of Stop Smoking Services.
The devices were compared against the ‘gold standard’ combination of nicotine replacement products and behavioural support.
Cancer Research UK’s Sophia Lowes said the results are “extremely positive”.
The most convincing evidence so far
The trial, published in The New England Journal of Medicine, included 886 smokers who were attending Stop Smoking Services at several locations in England.
More than half were given the nicotine replacement product of their choice for up to 3 months. The other half received an e-cigarette starter pack. People were given newer, refillable e-cigarettes while previous trials had only used early models.
Everyone had the same one-to-one behavioural sessions for at least 4 weeks that they would normally receive from Stop Smoking Services.
The study found that 18 out of 100 e-cig users were smoke-free after a year.
This was compared with around 10 in 100 people using NHS-approved nicotine replacement treatments, such as gum, patches, lozenges or sprays.
Confidence boost for recommending e-cigs
Professor Peter Hajek, who led the study, said: “Although a large number of smokers report that they have quit smoking successfully with the help of e-cigarettes, health professionals have been reluctant to recommend their use because of the lack of clear evidence from randomised controlled trials.”
Lowes said that Hajek’s trial “should give doctors, nurses, pharmacists and Stop Smoking Service advisers further confidence to recommend e-cigarettes as an effective means of quitting.”
Dunja Przulj, a health psychologist who worked on the study, added that recommending e-cigarettes as a stop smoking aid could further accelerate the reduction in smoking and in smoking related diseases.
More positive effects
Researchers also found that among those who did not stop smoking altogether, people who used e-cigarettes cut down the number of tobacco cigarettes they smoked by at least a half.
Participants in the e-cigarette group also reported that symptoms of smoking, such as coughing and phlegm production, improved after a year of vaping.
E-cigarette users said they experienced more throat and mouth irritation, and those using nicotine replacement experienced more nausea.
Results of a questionnaire showed that both products were perceived as less satisfying than cigarettes, but e-cigarettes provided higher satisfaction and were rated as more helpful than nicotine replacement treatment.
Lowes said that whether using nicotine replacement products, medication or e-cigarettes,“what is clear is that using the support available from local Stop Smoking Services gives smokers the best chance of quitting. Everyone is different, so smokers shouldn’t be afraid to experiment and find what works for them.”
Hajek, P et al. (2019) A Randomized Trial of E-Cigarettes versus Nicotine- Replacement Therapy. New England Journal of Medicine. DOI: 10.1056/NEJMoa1808779