E-Cigarette Smoking Cessation Research: What Do the Results Say?
A comprehensive study published in the New England Journal of Medicine compared electronic cigarettes with nicotine replacement therapy. While the group using e-cigarettes showed a higher one-year smoking cessation rate, the results must be interpreted correctly, and it should be remembered that e-cigarettes are not risk-free.
People attempting to quit smoking may experience nicotine withdrawal symptoms such as intense cravings, restlessness, irritability, difficulty concentrating, and low mood. Therefore, it is believed that the method used during the quitting process can affect not only the need for nicotine but also the person's habits and behaviors.
How Was the Study Conducted?
A total of 886 adults attending stop-smoking services in the UK participated in the randomized controlled trial published in the New England Journal of Medicine in 2019. Participants were randomly divided into two groups.
1. Nicotine Replacement Group
Participants were offered suitable options from nicotine replacement products, such as nicotine patches, nicotine gum, lozenges, mouth sprays, or similar products.
2. E-Cigarette Group
Participants were provided with a refillable e-cigarette starter kit and instructed on how to use the device. Subsequently, participants were allowed to use products of their choice.
Both groups received weekly face-to-face behavioral support during the first four weeks of the study. Thus, the study compared not just the products used, but two different methods applied alongside professional support.
| Study Outcome | E-Cigarette Group | NRT Group |
|---|---|---|
| One-year smoking abstinence rate | 18% | 9.9% |
| Continuing product use at 52 weeks* | 80% | 9% |
*This second comparison refers to the proportion of participants who succeeded in quitting smoking for a year and continued to use their assigned product.
What Was Observed in Nicotine Withdrawal Symptoms?
Relevant analyses of the study found higher treatment adherence among participants in the e-cigarette group. In particular, it was reported that smoking urges decreased more during the initial weeks and that e-cigarettes were found more satisfying by some participants compared to nicotine replacement products.
However, irritability, low mood, or restlessness experienced during the smoking cessation process do not depend solely on the product used. The degree of nicotine dependence, an individual's daily habits, environmental factors, and professional support received can also influence the process.
Are E-Cigarettes Risk-Free?
No. The fact that e-cigarettes do not contain tar and the numerous combustion products created by burning tobacco does not mean they are completely harmless. E-cigarette aerosols may contain nicotine and various substances that can affect the respiratory system. Research regarding long-term effects is ongoing.
For this reason, non-smokers, children, adolescents, pregnant women, and breastfeeding individuals are advised not to start using e-cigarettes. E-cigarettes are studied solely in the context of an alternative to continued smoking for adults who currently smoke.
How Are Current Scientific Findings Evaluated?
Subsequent systematic reviews have also reported evidence showing that nicotine-containing e-cigarettes can help some adult smokers quit smoking. However, these results do not imply that e-cigarettes are harmless, suitable for everyone, or guaranteed to deliver results on their own.
The best outcomes are usually associated with a person's determination to quit, receiving proper support, and completely stopping combustible tobacco use. Using both cigarettes and e-cigarettes concurrently over long periods does not eliminate the risks posed by combustible cigarettes.
Explore E-Cigarette Models
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E-Cigarette ModelsSummary of the Study
- A total of 886 adults participated in the study.
- Both groups received behavioral support for the first four weeks.
- The one-year cessation rate was 18% in the e-cigarette group.
- The rate in the nicotine replacement group was measured at 9.9%.
- Long-term product adherence was higher in the e-cigarette group.
- The results do not imply that e-cigarettes are completely harmless.
New England Journal of Medicine – A Randomized Trial of E-Cigarettes versus Nicotine-Replacement Therapy
PubMed Research Record
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