Vapes Help Quit Smoking

Research continues to show that vapes help more people quit smoking than other methods.The findings are life-and-death important.

Smokers who want to quit have the best chance of doing so if they use nicotine e-cigarettes, according to a new review by Cochrane, a London-based independent, international nonprofit research network specializing in evidence-based healthcare and, particularly, systematic reviews of medical research.

"Nicotine e-cigarettes, commonly known as vapes, are more effective in helping people quit smoking than many conventional methods such as nicotine gums and patches and quitting with behavioral support or no support at all," the review found.

Smoking is the leading cause of preventable disease and death, resulting in more than seven million deaths per year, including 1.6 million non-smokers who are exposed to second-hand smoke, according to the World Health Organization (WHO).

The analysis, part of an ongoing living systematic review that is updated as new evidence becomes available, examined 80 randomized controlled trials involving 29,861 participants, a release noted, nine of which were new to this latest update.

'A Proven and Viable Option'

The review found high-certainty evidence 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," the statement pointed out, "though this evidence is less certain due to risk of bias in the study design."

"We have very strong evidence that regulated nicotine e-cigarettes are substantially less harmful than smoking," said Dr. Jamie Hartmann-Boyce, senior author of the review from University of Massachusetts Amherst. "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, though 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.

"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," said Hartmann-Boyce. "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."

Incorporate Nicotine E-Cigarettes

Elsewhere, an interdisciplinary group of tobacco treatment experts is urging clinicians to broaden the treatment options they discuss with patients who want to stop smoking cigarettes.

In recommendations published recently in JAMA, the researchers outline how clinicians can incorporate nicotine e-cigarettes as part of patient-centered conversations about smoking cessation. The goal is not to encourage nicotine use but to help more people to stop smoking combustible cigarettes - the leading cause of preventable death in the U.S.

Developed by the Harm Reduction Work Group of the Society for Research on Nicotine and Tobacco's Treatment Research Network, the recommendations provide clinicians with practical guidance for discussing smoking cessation, according to a release. "Rather than taking a one-size-fits-all approach, the authors encourage clinicians to present patients with a 'menu of options' for quitting and work with them to weigh the risks and benefits."

The paper also includes a conversation guide that walks clinicians through key questions to consider, strategies for addressing common misconceptions and evidence-based recommendations for counseling patients who choose to use nicotine e-cigarettes.

"We've had clinicians asking us for years how they should talk to their patients about e-cigarettes, and we really didn't have anywhere to point them," said Alana Rojewski, Ph.D., Associate Director of the Tobacco Treatment Program at MUSC Hollings Cancer Center in the statement. "There was plenty of research literature but nothing that offered practical guidance on how to have these conversations in clinical practice."

"The main takeaway is for clinicians to include e-cigarettes in their toolkit of smoking cessation options," said Tracy Smith, Ph.D., an addiction scientist and co-leader of the Cancer Prevention and Control Research Program at Hollings.