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Can e-Cigarettes Aid Smoking Cessation?

Cochrane Database Syst Rev; ePub 2016 Sep 14; Hartmann-Boyce, et al

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The use of electronic cigarettes (ECs) containing nicotine increased the chances of smoking cessation in the long term when compared to using ECs without nicotine, according to an updated review of 2 studies involving 662 people. Initially, 24 studies were identified; 11 as being new for this version of the review. Eventually, the 2 studies comparing EC use containing nicotine with EC use with placebo (non-nicotine) were selected. Findings included:

• Participants using an EC were more likely to have abstained from smoking for at least 6 months compared with participants using placebo EC (RR, 2.29).

• 1 study that compared EC to nicotine patch found no significant difference in 6-month abstinence rates.

• None of the studies found that smokers who used EC short- to mid-term (≤2 years) had an increased health risk compared to smokers who did not use ECs.

Citation: Hartmann-Boyce J, McRobbie H, Bullen C, Begh R, Stead LF, Hajek P. Electronic cigarettes for smoking cessation. [Published online ahead of print September 14, 2016]. Cochrane Database Syst Rev. doi:10.1002/14651858.CD010216.pub3.

Commentary: The results of this Cochrane review support that e-cigarettes may be helpful as an aid for smoking cessation. This is not surprising since they contain nicotine. The larger concern with e-cigarettes that remains is the fact that most people who use ECs are not using them for smoking cessation, but rather are using them as a primary nicotine delivery device. This is particularly a concern for adolescents. During 2011 to 2015, substantial increases were observed in e-cigarette and hookah use among high school and middle school students, whereas significant decreases were observed in the use of cigarettes, resulting in no decline in tobacco use overall. During 2015, e-cigarettes were the most commonly used tobacco product among middle school (5.3%) and high school (16.0%) students.1 It also appears that e-cigarettes lead to a greater likelihood of going on to smoke regular tobacco products.2 —Neil Skolnik, MD

1. Singh T, Arrazola RA, Corey CG, et al. Tobacco use among middle and high school students—United States, 2011–2015. [Published online ahead of print April 15, 2016]. MMWR Morb Mortal Wkly Rep. 2016;65:361–367. doi:10.15585/mmwr.mm6514a1.

2. Leventhal AM, Strong DR, Kirkpatrick, et al. Association of electronic cigarette use with initiation of combustible tobacco product smoking in early adolescence. JAMA. 2015;314(7):700-707. doi:10.1001/jama.2015.8950.

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