Vaping twice as good as gum for quitting smoking finds study

By Dr. Ananya Mandal, MDJan 31 2019

A new study has revealed that using e-cigarettes are twice as effective as chewing nicotine containing gum or using nicotine skin patches in quitting smoking. The results of the study were published in the latest issue of the New England Journal of Medicine (NEJM).

Disposable vape pen. Image Credit: GrungeElfz / Shutterstock

A study involved 886 long term smokers who were ready to quit smoking. These participants had seeked help from the NHS to help them quit. In United Kingdom, experts believe that smoking e-cigarettes has brought down rates of smoking significantly and helped many quit.

Prof Peter Hajek from Queen Mary University of London and his team looked at the group of participants and assessed if vaping or nicotine replacement therapy were similarly effective in helping smokers quit. The smokers were mostly middle aged and were divided randomly intow two groups.

One group was supplied with e-cigarettes as a means to quit smoking while the other group was designated to receive nicotine replacement therapy. This involved use of nicotine chewing gum, lozenges, sprays and using nicotine skin patches.

In addition all participants were offered behavioural support during their efforts to quit. Results at the end of the year showed that 18 percent of those who were using e-cigarettes to smoke had quit smoking altogether and 9.9 percent using nicotine replacement therapy had stopped smoking. At the end of the year 80 percent of the vapers were still using the e-cigarettes while only 9 percent in the other group continued to use nicotine replacement.

Hajek explained that the fact that end of the year so many of the participants were still using e-cigarettes is a “potential problem” but also “potentially beneficial”. He said, “There are both sides to it and I think the beneficial side is stronger. The negative one is they are still using something and e-cigarettes are unlikely to be totally safe. They are unlikely to have more than about 5% of the risks of smoking but there is still some risk and if using it for one year means that they are using it for 30 years and if that generates some health risk then they would be better off not using it.”

Authors write that this is the first randomized trial that compared the two available and approved methods of quitting smoking. According to Hajek, “Although a large number of smokers report that they have quit smoking successfully with the help of e-cigarettes, health professionals have been reluctant to recommend their use because of the lack of clear evidence from randomised controlled trials. This is now likely to change.” Researchers in the United States do not agree with the usefulness of e-cigarettes in helping people quit smoking. Instead they say that the nicotine in the e-cigarettes are just as addictive and their flavours are attracting young adolescent smokers as well who are taking up vaping.

According to the researchers, the initial few days of quitting smoking are associated with symptoms such as irritability, lack of concentration etc. Those in the e-cigarette group experienced some amount of throat and mouth irritation as side effects of the therapy while those on nicotine replacement therapy said they experienced some degree of nausea.

At present use of e-cigarettes to help quit smoking is being supported by researchers in the UK as well as the Public Health England. Martin Dockrell, tobacco control lead at PHE said in a statement, “This landmark research shows that switching to an e-cigarette can be one of the most effective ways to quit smoking, especially when combined with face-to-face support. All stop-smoking services should welcome smokers who want to quit with the help of an e-cigarette.” The PHE has called for availability of e-cigarettes on the NHS within the next five years to help smokers quit.

US scientists Belinda Borrelli and George T O’Connor from the Henry M. Goldman school of dental medicine at Boston University wrote a comment paper in response to this study. Like many US scientists they disagree with the superiority of e-cigarettes over other measures that help people quit smoking. They write, “We recommend that e-cigarettes be used only when FDA-approved treatments (combined with behavioural counselling) fail, that patients be advised to use the lowest dose needed to manage their cravings and that there be a clear timeline and ‘off ramp’ for use.”