07 November 2013

More evidence e-cigs may help in quitting tobacco

Experts continue to debate whether or not e-cigarettes are smoking-cessation tools or just leisure products.

Experts say electronic cigarette users followed over a year reduced or quit using tobacco cigarettes in large numbers and were less prone to resume smoking, at least in the short term.

Experts continue to debate whether or not e-cigarettes are smoking-cessation tools or just leisure products. The electronic vaporisers use cartridges of liquid nicotine to deliver a flavoured nicotine-laced vapour without the by-products of burning tobacco in traditional cigarettes.

"Our results may not be applicable to all vapours," Jean-Francois Etter said, using the slang for vaporiser users.

He led the study at the Institute of Social and Preventive Medicine at the University of Geneva in Switzerland.

The results were published in the Addictive Behaviours journal.

Tobacco use

A few small studies have found that e-cigarettes seemed to help smokers quit using tobacco or at least to smoke fewer traditional cigarettes.

But there have been no long-term studies of how people actually use e-cigarettes, so experts are still unsure. The researchers posted a questionnaire on a French stop-smoking website and asked sites selling e-cigarettes to link to the questionnaire. Most "vipers" buy their e-cigarettes online.

They were asked to respond immediately, then a month later and a year later. Questions covered e-cigarette use, tobacco use and the date of quitting tobacco, if one applied.

Of more than 1 000 original recruits, 367 responded to all three surveys.

For those who had quit smoking already and were using e-cigarettes instead, 6% had relapsed to tobacco after one month. That number was stable after one year. Of those who were smoking and using e-cigarettes when the study began, 22% had quit smoking tobacco after a month and 46% had quit after a year.

 That group averaged 11.3 tobacco cigarettes daily at the beginning of the study and six cigarettes per day after one month.

Food flavouring

"This suggests that e-cigarettes  may help them quit, but our results need to be interpreted with caution because of the dropout rate at follow-up and the fact that our sample is not representative of all vapours," he said.

 In the short-term, e-cigs appear not to carry any health risks of their own, he said, but researchers still don't know the long-term health effects of inhaling the common solvent glycol and food flavouring over many years.

 Etter said e-cigarettes didn’t need to be 100% safe, but they needed to be significantly safer than tobacco cigarettes because they were primarily used by cigarette smokers.

Even though the evidence is still thin, Etter believes smokers should use e-cigarettes as quit-smoking aids and doctors should recommend them.

The director of the tobacco dependence research unit at Barts and The London School of Medicine and Dentistry in London, Professor Peer Hajek, said the products should not be treated as medical devices or drugs, even though they might have therapeutic benefits for patients.

Market monopoly

"Internet surveys are more likely to attract people who had a positive experience with e-cigarettes,” Hajek said.

 "The study is nevertheless innovative in that it did not just ask for once-off information as a number of previous studies did, but it followed up the e-cigarette users to see what happens to their e-cig use and to their smoking one year later."

 The new study adds to the evidence that e-cigarettes can help smokers quit or cut down, he said.

"There are two products competing for smokers' business.

"One kills half the users and the other one is at least an order of magnitude safer," Hajek said.

"It makes little sense to try to cripple the safer one so the deadly one maintains the market monopoly."


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