March 25, 2014
News Review From Harvard Medical School -- Study: E-Cigarettes Don't Help Smokers Quit
Electronic cigarettes (e-cigarettes) aren't all they're touted to be, according to a U.S. study. Researchers focused on whether they were effective smoking cessation tools. They found that e-cigarettes did not help people quit or cut down on smoking. The study followed 949 smokers. Of them, 88 said they were also using e-cigarettes at the start of the study in 2011. One year later, 14% of the total group had quit smoking. The e-cigarette group did not quit at a greater rate than the larger group. The study and its findings are not without controversy. Critics claim that the study was too small for the findings to be conclusive. The study was published in JAMA Internal Medicine online. HealthDay News reported on it March 24.
By Howard LeWine, M.D.
Harvard Medical School
What Is the Doctor's Reaction?
E-cigarettes have rapidly gained popularity. They are promoted as a safer alternative to regular cigarettes and a way to help you quit smoking. But neither of these claims is backed up by solid evidence.
E-cigarettes (short for electronic cigarettes) are battery-operated devices shaped like cigarettes. They give off a flavored vapor that contains nicotine. They give the illusion and feel of smoking a cigarette without burning tobacco. Some e-cigarette users say that they are "smoking." Others call it "vaping," to distinguish the vapor from smoke.
Some earlier studies suggested e-cigarettes might be an effective smoking cessation tool. But results of other studies did not support that claim. This report adds support to the "no help" side. It suggests e-cigarettes don’t help people smoke fewer tobacco products. They don't lead to quitting.
Critics of this report say that it is not a well-designed study and has too few participants to make the findings valid. Those are fair criticisms. But noting the study has flaws does not mean e-cigarettes should be considered a safe, effective method to help smokers quit.
What Changes Can I Make Now?
It’s always a good time to quit smoking. The first step is to set a quit date. Make it public. Share the special date with your family, friends and doctor.
The two main challenges to quitting are:
- Overcoming the nicotine addiction
- Breaking the smoking habit
Overcoming the nicotine addiction. Nicotine replacement therapy (NRT) doubles your chances of quitting successfully. It can help you get through the cravings. Nicotine patches, gum, nasal sprays, inhalers and lozenges are examples of NRT products.
NRT delivers a low dose of nicotine into the bloodstream. This eases, or even erases, withdrawal symptoms. Unlike smoking, NRT produces relatively constant blood levels of nicotine without the toxic chemicals in tobacco.
Some medications used to help people quit smoking do not release nicotine into the bloodstream. Instead, they act on the brain to decrease the cravings for nicotine, nicotine withdrawal symptoms or both. The two that doctors prescribe the most are varenicline (Chantix) and bupropion (Wellbutrin, Zyban).
Varenicline works two ways. It partly imitates the effects of nicotine, thereby cutting down cravings and withdrawal symptoms. It also partially blocks the effect of nicotine, causing a smoker to get less of a reward.
Bupropion is an antidepressant that also helps reduce the desire to smoke. It works by triggering some of the same receptors as nicotine.
Breaking the smoking habit. When smokers quit, they need to finds ways to fill the void. Ways to break the rituals, daily habits, social encounters and emotionally charged moments that can trigger the impulse to light up. Behavioral therapy, smoking cessation programs and support groups can help.
Your best chance of success is to simultaneously commit to lessening the nicotine withdrawal symptoms and making changes in behavior to break the smoking habit.
What Can I Expect Looking to the Future?
More studies looking at the safety and effectiveness of e-cigarettes as a smoking cessation therapy are in progress.