A landmark study has been published by leading health experts to compare the effectiveness of e-cigarettes and nicotine-replacement therapies (NRTs) in helping smokers quit cigarettes. The research was led by Professor Peter Hajek and published in the New England Journal of Medicine. The conclusions drawn are very encouraging.

This study is particularly important as it’s an area which has attracted limited academic research. The relative safety of vaping compared with smoking has been covered numerous times, with Public Health England (PHE) estimating from credible literature review that vaping is 95% less harmful than smoking. However the effectiveness of e-cigarettes helping people quit had not previously been explored in much detail.

The Study

The trial consisted of 886 participants from the UK, who were randomly put into two groups. One group were given a vaping start up kit and the other group were given NRTs. The vaping start up kit consisted of an e-cigarette and one or two bottles of e-liquid. The nicotine replacement therapies were selected by the group participants, and included patches, gum, lozenges, spray or combinations. All the participants received the same multi-session behavioural support as per UK stop smoking service practise.

The results showed that 18% of smokers who were given an e-cigarette remained smoke-free after a year. For those using NRTs, the quit rate in the same 1-year time period was considerably lower at 9.9%.

Furthermore, for those who didn’t quit completely, more of those who were vaping reduced their cigarette consumption by at least 50%. The results also showed that e-cigarettes were rated as better than NRTs in terms of satisfaction.

It has been suggested that some primary care professionals and stop smoking services have been hesitant in recommending e-cigarettes due to a lack of clinical research on their effectiveness for smoking cessation. However, this study provides clear evidence that e-cigarettes are a significantly more effective tool for quitting smoking in comparison to universally recommended NRTs.

Lead author, Professor Peter Hajek said: “Although a large number of smokers report that they have quit smoking successfully with the help of e-cigarettes, health professionals have been reluctant to recommend their use because of the lack of clear evidence from randomised controlled trials.

“This is now likely to change.”

Those familiar with vaping will already know how effective vaping is in helping smokers quit. However, smokers and health professionals may not have experienced this first hand so could perhaps be forgiven for remaining hesitant. This new high-quality research should now help to give cessation counsellors, doctors and GPs the confidence to suggest e-cigarettes as a viable option to quit smoking.

Misleading study

Some of the aforementioned vaping reluctance undoubtedly stems from misleading, poor-quality research. This was particularly prevalent in the 48 hours leading up to the release of Professor Hajek’s study. Irresponsible headlines emotively read “E-cigarettes increase the risk of stroke and heart disease”, a totally inaccurate conclusion drawn by completely flawed research methods.

Robert West, Professor of Health Psychology at UCL tweeted, “there just isn’t time to dissect every piece of nonsense put out by these people.”

Fortunately, world-renowned e-cigarette researcher Dr Konstantinos Farsalinos was on hand to expose the fallacy of the headlines with an accurate appraisal. In an article yesterday, he explained that:

“Both these conclusions are simply wrong and constitute epidemiological malpractice and misinformation. “Increasing the risk” means that someone is FIRST exposed to a condition (in this case, exposed to e-cigarette use) and THEN, BECAUSE OF THIS EXPOSURE, he/she develops disease. Both studies CANNOT provide any of this information to substantiate an increased risk.”

We hope that the important research from Professor Hajek et al. cuts through the nonsense so often seen in the newspapers, giving smokers better potential access to a highly effective (and in so many cases life changing) opportunity. We welcome all well conducted research surround vaping, and we hope that medical professionals and policy makers will take note of responsible and credible studies, while identifying and dismissing misleading research that has had extremely negative consequences for public health.

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