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In recent years, e-cigarettes have been widely marketed as a safer alternative to smoking, though critics say they increase the risk of life-long nicotine additions from vaping among prior non-smokers. Now, the findings of a new study suggest that even among cigarette smokers, any benefit provided by e-cigarettes in helping them quit appears to be effective for only a short period of time.
Canadian researchers indicate that use of e-cigarettes to help quit smoking, along with counseling, is twice as effective than counseling alone at first. However, the benefit only appears to be short term., according to findings published this week in the Journal of the American Medical Association (JAMA).
Researchers conducted a randomized clinical trial enrolling 376 adults. Participants were randomized to a nicotine e-cigarettes plus counseling group, a non-nicotine e-cigarettes plus counseling group, or a counseling alone group. The study ran from November 2016 to September 2019 at 17 Canadian sites.
The data indicates using e-cigarettes with nicotine plus smoking cessation counseling had a significantly greater effect on helping users quit smoking traditional tobacco cigarettes. Abstinence was 22% at 12 weeks for the combo group, compared to only 9% for smoking cessation counseling alone. However, by 24 weeks the difference was not as significant. The combo group had an abstinence rate of 17%, compared to 10% in the counseling-only group.
This could be because e-cigarettes may be just as addictive as traditional cigarettes. This can increase a person’s dependence on nicotine overall, even if it is a different method of delivery. Some users may return to cigarette smoking after using e-cigarettes.
The findings of the new study also focused on a third group that used non-nicotine e-cigarettes and counseling. The abstinence rate was not significantly different from counseling alone at 12 weeks, 17% had stopped smoking compared to 9%. However, by the 24 week mark the rate increased to 20% for the combo group using non-nicotine e-cigarettes and counseling compared to 10% for counseling only.
Adverse events were common in all groups, The most common was cough and dry mouth. Roughly 64% of participants experienced cough and 53% dry mouth.
Most of the study participants were long-time smokers and had tried other methods of quitting. Many people advocate e-cigarettes as a method of quitting tobacco cigarettes, but research indicates quitting e-cigarettes may be even harder than quitting traditional cigarettes. This may be due to the high delivery rates of nicotine in many e-cigarette devices.
E-cigarettes also expose users to carcinogenic chemicals, much like tobacco cigarettes, and increase their risk of respiratory issues and problems with blood flow and can lead to heart attacks and strokes.
“Among adults motivated to quit smoking, nicotine e-cigarettes plus counseling vs counseling alone significantly increased point prevalence abstinence at 12 weeks,” the researchers concluded. “However, the difference was no longer significant at 24 weeks, and trial interpretation is limited by early termination and inconsistent findings for nicotine and nonnicotine e-cigarettes, suggesting further research is needed.”