E-Cigarettes Help Dependent Smokers More Than Nicotine Replacement Therapy

According to the results of a clinical trial conducted by Queen Mary University of London, e-cigarettes are more effective than nicotine replacement therapy in achieving long-term smoking reduction and cessation.

About 80% of smokers receiving intensive treatment continue to smoke after one year. Smokers may benefit from approaches that reduce the harm of smoking without immediately stopping nicotine use, while still retaining the option to quit nicotine later. Nicotine replacement therapies (NRT), such as patches, gum, nasal/oral sprays, and inhalers, have been approved for this approach for more than 30 years. They are effective, especially when accompanied by behavioral support, but their overall results are moderate.

In the first study of its kind, researchers recruited 135 smokers who had been unable to quit through conventional treatment. They were randomly assigned to receive either an 8-week supply of NRT of their choice or an e-cigarette starter kit, along with instructions on how to purchase more e-liquid in the strength and flavor of their choice. The products were accompanied by minimal smoking cessation behavioral support.

The results, published in the journal Addiction, found a significant difference in smoking reduction, including complete cessation, in the e-cigarette group. After six months, 27% of participants in the e-cigarette group had reduced their cigarette consumption by at least half, compared with 6% in the NRT group. Carbon monoxide readings in participants’ breath confirmed that there was also a significant difference in complete quit rates—19% of participants in the e-cigarette group had quit smoking, compared with 3% in the NRT group.

The results suggest that for dependent smokers, recommending a refillable e-cigarette with e-liquid strength and flavor chosen by the patient is more effective than prescribing NRT. The cost of an e-cigarette starter kit was also far lower than NRT.

Dr. Katie Myers Smith, lead researcher and health psychologist at Queen Mary University of London, said: “These results have important clinical implications for smokers who were previously unable to quit through conventional treatment. E-cigarettes should be recommended to smokers who have struggled to quit using other methods, especially where behavioral support is limited.”

Michelle Mitchell, Chief Executive of Cancer Research UK, which funded the study, said: “This study shows that e-cigarettes can be a very effective tool for people who want to quit smoking, including those who have tried before. Research to date suggests that vaping is far less harmful than smoking. But e-cigarettes are not risk-free, and we still do not know their long-term effects, so people who have never smoked should not use them.

“It is important to switch completely in order to gain the benefits and reduce the risk of cancer. Talk to your GP or local free stop-smoking service to find the best option for you.”