Landmark review: Vapes twice as good as NRT at helping smokers quit

Vapes are better than nicotine-replacement patches and gums at helping smokers quit, influential researchers ruled today.

• Smokers using electronic cigarettes are up to twice as likely to give up the habit

• Oxford University experts found ‘high-certainty evidence’ vapes help quitting

• Cancer charities and experts said they ‘welcome’ the findings of the report

Oxford University researchers found smokers using electronic cigarettes are up to twice as likely to give up the habit for six months.

Cancer experts welcomed the report, which adds to the growing pile of evidence that shows e-cigarettes are effective quit-smoking tools.

But they warned non-smokers not to take up vaping because ‘they are a relatively new product and we don’t yet know the long-term health effects’.

Author Dr Nicola Lindson, a psychologist at the university, said the products carry only a small fraction of the risk of smoking but aren’t ‘risk free’.

Currently, the NHS advises that vaping can help smokers – though it is not available on prescription.

But England is set to become the first country in the world to prescribe e-cigarettes to help smokers quit, if Government plans are given the go ahead.

The proportion of people vaping in the UK more than doubled this year, from 4 per cent in 2021 to 8.6 per cent in 2022.

Around 5 per cent of US adults vape.

Recent surges in prevalence have largely been driven by young people taking up electronic cigarettes, prompting concern from some experts.

Earlier this month, respiratory paediatricians told MailOnline the colourful devices need graphic cigarette-style warnings slapped on them.

Despite the concerns around child use, Dr Lindson said: ‘E-cigarettes do not burn tobacco; and as such they do not expose users to the same complex mix of chemicals that cause diseases in people smoking conventional cigarettes.

‘E-cigarettes are not risk free, and shouldn’t be used by people who don’t smoke or aren’t at risk of smoking.

‘However, evidence shows that nicotine e-cigarettes carry only a small fraction of the risk of smoking.’

The 290-page Cochrane Review included 78 studies in over 22,000 participants, 22 more studies since the last update in 2021.

They looked at data of smokers who were trying to quit and compared their success with e-cigarettes and other therapies over six months.

These included nicotine replacement therapy, such as patches and gums, varenicline — a medicine to help people stop smoking — and both nicotine and non-nicotine e-cigarettes.

Some studies also compared these success rates to having no support to quit.

Researchers also looked at studies investigating side-effects of the therapies on or after at least one week of use.

Results showed that if six in 100 people quit by using nicotine replacement therapy, eight to twelve would quit by using electronic cigarettes containing nicotine.

This means an additional two to six people in 100 could potentially quit smoking with nicotine containing electronic cigarettes.

Evidence also suggested that nicotine e-cigarettes led to higher quit rates than e-cigarettes without nicotine, or no stop smoking intervention, but less data contributed to these analyses.

Lead author Dr Jamie Hartmann-Boyce said: ‘Electronic cigarettes have generated a lot of misunderstanding in both the public health community and the popular press since their introduction over a decade ago.

‘For the first time, this has given us high-certainty evidence that e-cigarettes are even more effective at helping people to quit smoking than traditional nicotine replacement therapies, like patches or gums.’

In studies comparing nicotine e-cigarettes to nicotine replacement treatment, significant side effects were rare.

Nicotine e-cigarettes cased throat or mouth irritation, headache, cough, and feeling nauseous in users for up to the first two years.

However, these effects appeared to diminish over time.

Michelle Mitchell, chief executive at Cancer Research UK, said: ‘We welcome this report which adds to a growing body of evidence showing that e-cigarettes are an effective smoking cessation tool.

‘We strongly discourage those who have never smoked from using e-cigarettes, especially young people.’

‘This is because they are a relatively new product and we don’t yet know the long term health effects.’

She added: ‘While the long term effects of vaping are still unknown, the harmful effects of smoking are indisputable – smoking causes around 55,000 cancer deaths in the UK every year.

‘Cancer Research UK supports balanced evidence-based regulation on e-cigarettes from UK governments which maximises their potential to help people stop smoking, whilst minimising the risk of uptake among others.’

The researchers conclude that more evidence, particularly about the effects of newer e-cigarettes with better nicotine delivery than earlier ones, is needed to assist more people quit smoking.

Longer-term data is also needed, they said.

Independent experts said the results should ‘provide reassurance to smokers’ e-cigarettes could help them quit.

Dr Sarah Jackson, principal research fellow of the University College London Tobacco and Alcohol Research Group, said: ‘E-cigarettes are popular among smokers who want to quit, with one in every three quit attempts in England involving an e-cigarette.

‘A growing number of trials have tested whether e-cigarettes make smokers more likely to quit successfully. This review provides the most rigorous and up-to-date summary of this evidence.

‘With more data available than ever before, the authors concluded that there is now high-certainty evidence that e-cigarettes are even more effective in helping people to quit than traditional nicotine replacement therapies, such as nicotine patches and gum.

‘These findings follow a recent review of the harms of e-cigarettes, which showed clear evidence that vaping poses only a small fraction of the health risks of smoking.

‘Taken together, these reports should provide reassurance to smokers that e-cigarettes are much safer to use and can increase your chances of quitting.’

Read full article here.

Joe Davies – Daily Mail – 2022-11-17.