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Proponents of e-cigarettes note the product contains no carbon monoxide, tar or other tobacco residue. The inhaled vapor in e-cigarettes is primarily nicotine.
Additionally, some proponents of e-cigarettes declare the product is associated with reduction or cessation of tobacco-based cigarette use.
Unfortunately, this is an area where public health trends come before scientific research data is collected. Few studies of the safety and effectiveness of e-cigarettes in smoking cessation have been published.
One large study of electronic cigarettes and smoking cessation was completed and recently published in the journal Lancet.
In this study, 657 smokers who wanted to quit were randomized one of three interventions: 16 mg nicotine e-cigarettes, 21 mg nicotine patches or placebo e-cigarette (nicotine free). Abstinence from cigarettes was verified by low concentrations of carbon monoxide.
At the end of the study the cigarette abstinence rates for the three groups were:
- E-cigarettes: 7.3%
- Nicotine patch: 5.8%
- Placebo e-cigarettes: 4.1%
These low rates of abstinence across all interventions were surprising to the researchers conducting the study. The overall low rates of abstinence reduced the statistical power of the study and no statistical difference across the three groups could be proven.
Some smokers adopting e-cigarettes do not desire or intent to quit. In this group, a separate research question is what is the natural history of cigarette smoking in high-risk populations who start to use e-cigarettes?
One small study looking at this question has been published in a group of 14 smokers with schizophrenia.
In this study, smoking subjects were allowed to use ad lib an e-cigarette product. Subjects kept a diary of the number of tobacco cigarettes smoked.
The results of this study found 2 of the 14 subjects quit tobacco cigarettes over the year long course of the study. An additional seven subjects reduced the number of cigarettes smoked by 50% or more by the end of the study. No adverse effects on schizophrenia symptoms levels were noted by participation in this study.
With such a limited research database, it is really too early to make a recommendation about e-cigarettes as a tool for smoking cessation.
There are quite a few studies in the pipeline that should inform smokers and clinicians. A query using the search term e-cigarette at the clinicaltrials.gov website produced 27 research study listings. Readers can access this list here.
Readers with more interest in the two studies summarized here can access the abstracts and free full-text (schizophrenia study only) in the citations below.
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Bullen, C., Howe, C., Laugesen, M., McRobbie, H., Parag, V., Williman, J., & Walker, N. (2013). Electronic cigarettes for smoking cessation: a randomised controlled trial The Lancet, 382 (9905), 1629-1637 DOI: 10.1016/S0140-6736(13)61842-5
Caponnetto P, Auditore R, Russo C, Cappello GC, & Polosa R (2013). Impact of an electronic cigarette on smoking reduction and cessation in schizophrenic smokers: a prospective 12-month pilot study. International journal of environmental research and public health, 10 (2), 446-61 PMID: 23358230
