Wednesday 21 May 2014 - 8am PST
Though some health officials have warned that electronic cigarettes should not be marketed as smoking cessation aids, a new study finds that, among people who are trying to quit without professional help, those who use electronic cigarettes are 60% more likely to succeed, compared with those who use willpower or nicotine replacement therapies.
The study, conducted by researchers at University College London (UCL) in the UK, is published in the journal Addiction.
According to the study authors, smoking kills an estimated 6 million people around the world each year. One of the leading risk factors for premature death and disability, tobacco use is linked to cancer, heart disease and stroke, among other adverse outcomes.
The devices provide nicotine using a battery-powered heating element activated by suction to heat a nicotine solution and transform it into a vapor.
"By providing a vapor containing nicotine without tobacco combustion," the authors write, "e-cigarettes appear to reduce craving and withdrawal associated with abstinence in smokers while toxicity testing suggests that they are much safer to the user than ordinary cigarettes."
In the US, use of e-cigarettes among smokers has increased from 2% in 2010 to over 30% in 2012, and the study authors note these rates are similar in the UK.
To further investigate the impact e-cigarettes may have on quitting smoking, the researchers surveyed over 5,800 smokers between 2009 and 2014 who attempted to stop smoking without prescription medicine or professional support.
After adjusting for factors that could influence success at quitting - including age, nicotine dependence and previous quit attempts - the researchers found that 20% of those who tried to quit by using e-cigarettes reported having ceased smoking conventional cigarettes.
By comparison, only 10.1% of those who used nicotine replacement therapies, such as patches or gum, reported stopping smoking, and 15.4% of those who tried to quit without help stopped smoking.
Senior author Prof. Robert West, of UCL's Department of Epidemiology & Public Health, says e-cigarettes could improve public health "because of their widespread appeal and the huge health gains associated with stopping smoking."
He and his team plan to continue monitoring success rates in individuals who use e-cigarettes to see whether this positive trend continues.
"It is not clear whether long-term use of e-cigarettes carries health risks, but from what is known about the contents of the vapor, these will be much less than from smoking."
Prof. West says some "public health experts have expressed concern that widespread use of e-cigarettes could 're-normalize' smoking," but he adds that they are tracking this closely and have not observed any evidence to support this theory.
Though the team's findings are significant, there are some limitations to the study. First and foremost, smoking cessation was not verified biochemically. Because the participants self-reported their success, they could have felt social pressure to report that they had stopped smoking when they actually had not.
Additionally, the research relied on participants recalling data from the previous 12 months, which could introduce "scope for bias."
Another limitation the researchers identify is that there is significant variability in nicotine vaporization between different types of e-cigarettes.
"Given this huge variability, it may be many years before one could accumulate enough real-world data to address these questions," the researchers conclude.
"We recognize the dangers posed to respiratory health by smoking tobacco, and it is clear that there is considerable public support behind efforts to reduce tobacco use in the UK. However, more research needs to be done into the safety and effectiveness of e-cigarettes, and manufacturers must work toward minimizing all harmful ingredients."