UK study shows e-cigarettes help adult smokers quit, but US experts urge caution

(CNN) When combined with one-on-one behavior therapy, e-cigarettes are more effective in helping people quit smoking than traditional nicotine-replacement products such as patches and gum, according to a new randomized study of British adults published Wednesday in the New England Journal of Medicine.

“E-cigarettes were almost twice as effective as the ‘gold standard’ combination of nicotine replacement products,” lead researcher Peter Hajek from Queen Mary University of London said in a statement.

“Health professionals have been reluctant to recommend their [e-cigarette] use because of the lack of clear evidence from randomized controlled trials. This is now likely to change.”
But US researchers urge caution, saying the study’s results are not conclusive or easy to generalize. They also point to the unknown long-term health effects of e-cigarette vapor on the body, as well as dangers of possibly encouraging e-cigarette use among teens.

Positive response in the UK

The study’s results have already been widely embraced by experts in the UK, many of whom agree that e-cigarettes should be included in adult anti-smoking efforts.

“This study should reassure policymakers and health professionals — mainly beyond the UK — who have until now been hesitant to recommend e-cigarettes for smoking cessation on the basis that there was a lack of high-quality trial evidence,” said Jamie Brown, who serves as deputy director of the Tobacco and Alcohol Research Group at University College London.

“We need to help as many people as possible to give themselves the best chance of success by using aids like e-cigarettes each time they try to stop smoking,” Paul Aveyard, a professor of behavioral medicine at the University of Oxford, said in a response to the study.

But American researchers and policy makers are not convinced.

First randomized study to use ‘modern’ e-cigs

Past research using e-cigarettes as adult smoking cessation aids has been inconclusive. Many were observational and did not objectively measure a smoker’s success at quitting. Others used older, first generation e-cigarettes that were poor substitutes for nicotine delivery.

Today’s 400-plus e-cigarette brands are small, unobtrusive and easier to use than the older types. They also come in hundreds of flavors and are much more powerful in delivering nicotine to ease a smoker’s cravings. In fact, researchers worry that e-cigarettes can be more nicotine-laden than traditional cigarettes.

For example, one Juul pod — a cartridge of nicotine-rich liquid that users plug into the dominant e-cig brand — contains the same amount of nicotine as a full pack of cigarettes.

One of the strengths of the UK study, said lead researcher Hajek, was that it was the first to use and test the “efficacy of modern e-cigarettes in helping smokers quit.”

Borrelli agrees the study had numerous strengths: “They biochemically verified smoking outcomes. They did rigorous data analysis, they had long-term outcomes. They let people choose their e-liquid, they let people choose their nicotine replacement therapy. And it was conducted in the real world.”



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