In a trial of e-cigarettes among Italian smokers with no
desire to quit using tobacco at the outset, up to 13% of participants were not
smoking regular cigarettes at all a year later.
Though the study was not billed as a smoking-cessation test,
more than half of participants cut down on tobacco soon after they started
using the e-cigarettes. And the percentage who quit smoking entirely by the end
rivals results achieved with medications, the authors note in the journal PLOS
"I think the main message of the study is that we can
use these products as an extraordinary tobacco control tool," Dr Riccardo
Polosa, the new study's senior author from the University of Catania, told
Reuters Health."This really is the first clinical trial that's ever been
reported on electronic cigarettes. There has been survey evidence and anecdotal
reports, but this is the first serious study," said Dr Michael Siegel, who
studies e-cigarettes but wasn't involved in the new research.
E-cigarettes were first introduced in China in 2004. The
battery-powered devices let users inhale nicotine-infused vapours, which don't
contain the harmful tar and carbon monoxide in tobacco smoke. While past
studies have looked at the use of e-cigarettes, the new study is the first to
follow hundreds of smokers for an entire year. It did not, however, compare the
devices to traditional nicotine replacement therapies, such as gum or patches.
To see how many e-cigarette users would cut down or quit
smoking cigarettes without any encouragement, the researchers recruited 300
people between June 2010 and February 2011. All were current smokers who stated
they had no intention of quitting in the near future. Each participant was then
randomised into one of three groups.
One group received e-cigarettes along with cartridges
containing 7.2 milligram (mg) of nicotine. Another group also received the
devices and 7.2 mg nicotine cartridges, but later in the study were
switched to 5.4 mg nicotine cartridges. And a third group got e-cigarettes and
cartridges containing only tobacco flavour but no nicotine.
Each participant received enough supplies to last three
months and went for regular checkups throughout the year. At the end of the
study, 13% of the group that first received the highest-dose nicotine
cartridges was no longer smoking. That compared to 9% of those who were in the
reduced-nicotine group and 4% in the group without nicotine.
Since there was no control group of smokers who got no
e-cigarettes at all, it's hard to know how many would have quit smoking on
their own by the end of a year, experts noted. Siegel, a professor at the
Boston University School of Public Health, said he would expect about 2% of the
participants to quit within a year if they weren't involved in a study.
However, Polosa's team also found that between 9 and 12% of
people in each of the nicotine-cartridge groups had reduced the amount they
smoked by at least half."The study is very positive in that it shows if
you smoke even a low- or medium-strength e-cigarette, you can get some
increased quitting and decreased smoking," Dr Murray Laugesen, a tobacco
and nicotine researcher who was not involved with the new study, told Reuters
"It also has to be acknowledged that these are good
results in people who had no intention of quitting," said Laugesen, a
public health medicine specialist at Health New Zealand Ltd in Christchurch. He
is also involved in an e-cigarette clinical trial and hopes to present the
results in September.
Siegel told Reuters Health that what's attractive about
e-cigarettes is they can not only provide the nicotine that smokers crave
without other harmful substances, they allow people to mimic their traditional
Researchers said that's one reason why e-cigarettes might
turn out to be a better form of nicotine replacement therapy than patches and
gums, but there's no data yet to prove it. "I think that's why they...
found the people who actually got no-nicotine electronic cigarettes had some
sort of quitting behaviour... But obviously the people who got the nicotine and
the high dose of nicotine did the best.
Clearly having the nicotine and device structure is
ideal," Siegel said. But he cautioned that more research is needed --
especially on the long-term safety of e-cigarettes and how the devices stack up
against traditional smoking cessation methods."My advice to people is to
try the traditional therapy first. But I think electronic cigarettes are for
people who have tried and failed nicotine replacement therapy, which is, sadly,
most people," Siegel added.