Wednesday, May 21, 2014

Evidence builds that e-cigarettes help smokers quit - Boston Globe

As a health reporter, I hate covering flip-flopping studies like a March finding that electronic cigarettes don't help smokers quit and a new British study finding that they do. Here's the simple explanation for the conflicting findings: The first study that found e-cigarettes were useless for quitting did not look specifically at those who were actually trying to stop smoking — while the more recent study finding did.

It surveyed 5,863 smokers between 2009 and 2014 who had made a serious attempt to quit over the past year using either e-cigarettes — which have battery-operated cartridges to heat liquid nicotine that's inhaled as a vapor — or over-the-counter cessation aids like nicotine patches, gum or lozenges, or nothing at all to help them quit. The study found that e-cigarette users were 60 percent more likely to have been successful in their quitting efforts compared to those in the other two groups; the researchers took into account income level, nicotine dependence, and other differences between those who used e-cigarettes and those who didn't.

"This was a real-world observational study to see how well e-cigarettes work when used specifically to help people stop smoking," said study author Dr Jamie Brown, a senior research associate at University College in London. "The trade-off is we cannot definitively rule out that an unmeasured factor may have influenced the result."

One clinical trial last year found that e-cigarettes were slightly more effective than nicotine patches for helping smokers quit, while another found that e-cigarettes helped smokers quit regardless of whether they contained nicotine or were placebo devices without any nicotine at all. In both trials, though, fewer than 10 percent of e-cigarette users were able to completely give up smoking tobacco cigarettes by the end of the studies.

In Brown's population study, nearly 20 percent of the e-cigarette users reported that they were no longer smoking regular cigarettes more than six months after they quit compared to 8 percent of those who used an over-the-counter product and 17 percent who used nothing at all.

"This finding suggests that there's a reason to be cautiously optimistic about the effects that e-cigarettes may be having on helping smokers quit," Brown said. It could be that many find their tobacco cravings are more easily overcome when they mimic the habit of lighting up and puffing.

Still, he added, more studies would help clarify how effective the trendy vapor devices really are for smoking cessation.

There's been a lot more research on the effectiveness of other methods like behavioral counseling with a medical professional or prescription medications approved to help smokers quit like Chantix (varenicline) and Zyban (bupropion). Both of these are more effective than over-the-counter nicotine aids, according to Brown, but whether these are better than e-cigarettes aren't known. His study excluded those who tried to quit using either professional help or prescription medications.

Deborah Kotz can be reached at dkotz@globe.com. Follow her on Twitter @debkotz2.

Source : http://www.bostonglobe.com/lifestyle/health-wellness/2014/05/21/evidence-builds-that-cigarettes-help-smokers-quit/ECir3qXpjo4ZowUr0UQ14J/story.html