E-cigarettes vs. Nicotine-Replacement Therapy for smoking cessation

In a randomized trial, 1-year abstinence from smoking was more likely with electronic cigarettes.

Proponents of electronic cigarettes often advocate the use of e-cigarettes (“vaping”) to facilitate smoking cessation. In a recent U.K. study, researchers identified 884 adult smokers who chose a quit date and were randomized to either e-cigarettes or nicotine-replacement therapy. Those in the e-cigarette group were given starter kits; those in the nicotine-replacement group were permitted to choose from various products (e.g., patches, gum, lozenges); many used combinations of products. All participants were given multisession behavioral support.

The rates of abstinence from smoking at 1 year were 18% in the e-cigarette group and 10% in the nicotine-replacement group (P<0.001). Among abstainers in the e-cigarette group, 80% still were using e-cigarettes at 1 year; among abstainers in the nicotine-replacement group, only 9% were still using nicotine-replacement products at 1 year.

nicotine replacement therapy

Nicotine Replacement Therapy (NRT) products

E-cigarettes were more effective than nicotine replacement in facilitating smoking cessation; however, many participants in the e-cigarette group who stopped smoking combustible tobacco continued to use e-cigarettes at 1 year. This study’s 1-year abstinence rates in the 10% to 20% range are typical for pharmacologic smoking-cessation interventions.

Readers with interest in this topic should have a look at the two accompanying editorials. Borrelli and O’Connor recommend that e-cigarettes be used for smoking cessation “only when FDA-approved treatments fail.” Drazen and colleagues focus particularly on nicotine addiction in young people and argue that the FDA should ban flavored nicotine products for e-cigarettes.


Tareq Salahuddin

Dr. Tareq Salahuddin is an award-winning journalist and a Special Correspondent of News Hour. He is a Public Health Professional working in the development sector. Dr. Tareq, a medical graduate, is a member of Public Health Association of Bangladesh and a former member of the Governing Council and Policy Committee of the World Federation of Public Health Associations (WFPHA), a J2J Fellow on HIV/AIDS and a member of the International AIDS Society. To know more about Dr. Tareq, please visit his personal website (www.tareqsalahuddin.net) or simply Google his name.
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