Smoking Cessation and Electronic Cigarettes

Dr. Chris Bullen MBChB MPH PhD FAFPM FNZCPHM Director School of Population Health, The University of Auckland Private Bag 92019 Auckland 1142, New Zealand Co-Director of the NZ Tobacco Control Research Turanga: A national programme of research to inform rapid smoking prevalence reduction.MedicalResearch.com Interview with:

Dr. Chris Bullen MBChB MPH PhD FAFPM FNZCPHM
Director
School of Population Health, The University of Auckland
Private Bag 92019 Auckland 1142, New Zealand
Co-Director of the NZ Tobacco Control Research Turanga: A national programme of research to inform rapid smoking prevalence reduction.
Web: http://www.turanga.org.nz/

MedicalResearch.com: What are the main findings of the study?

Dr. Bullen:

  • E-cigarettes, with or without nicotine, were modestly effective at helping smokers to quit, with similar levels of abstinence as with nicotine patches, and few adverse events.
  • At 6 months, verified abstinence was 7·3% with nicotine e-cigarettes, 5·8% with patches, and 4·1% with placebo e-cigarettes. However, there was insufficient statistical power to conclude superiority of nicotine e-cigarettes to patches or to placebo e-cigarettes.
  • No significant differences in rates of adverse events occurrence were found between the groups.
  • E-cigarettes were very popular throughout the trial, with almost 90% of users stating they would recommend them to a friend trying to quit smoking.


MedicalResearch.com: Were any of the findings unexpected?

Dr. Bullen:

  • Smoking abstinence rates were lower than expected, for e-cigarettes in particular, but also for those in the patches group.
  • High levels of continued use of e-cigarettes were found at 6 months, in participants allocated to e-cigarette and those allocated to patches .

MedicalResearch.com: What should clinicians and patients take away from your report?

Dr. Bullen:

  • E cigarettes are about as effective as nicotine patches for quitting, when used with minimal behavioural support.
  • In the short term (3 to 6 months use) using e-cigarettes appears to be no more harmful than using nicotine patches.
  • We have very limited data on longer term use of e-cigarettes, but such data as exists suggests the levels of toxins are far lower than in tobacco smoke (the only alternative to using e-cigarettes for many people) so there is little doubt they are a less harmful option than continuing to smoke.
  • They may be considered as an option for some people, who want to quit and stay abstinent, who have tried and failed to do so after trying standard NRTs and other evidence-based cessation medications.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Dr. Bullen:

  • Long term follow up of users who use e-cigarettes for more than 6 months, to monitor adverse effects of long-term use and concurrent use of tobacco products.
  • Further cessation and reduction trials of newer models of e-cigarettes that deliver nicotine more reliably and efficiently
  • Studies of youth uptake of e-cigarettes as a pathway to tobacco use or nicotine dependence.

Citation:

Electronic cigarettes for smoking cessation: a randomised controlled trial

Dr Christopher Bullen MBChB, Colin Howe PhD,  Murray Laugesen MBChB, Hayden McRobbie ,MBChB, Varsha Parag MSc, Jonathan Williman PhD, Natalie Walker PhD,
The Lancet, Early Online Publication, 9 September 2013