Published: Sun, July 30, 2017
Medical | By Garry George

Leader comment: Jury is out on e-cigarettes

Leader comment: Jury is out on e-cigarettes

According to the Centers for Disease Control and Prevention, cigarette smoking is still the leading cause of preventable death in the U.S. The agency says tobacco kills more than 480,000 people every year. "If every smoker was to change over to e-cigarettes completely, there would be a dramatic and nearly immediate public health benefit", said Chris Bullen, a professor of public health at the University of Auckland.

The data was collected via the The US Current Population Survey-Tobacco Use Supplement (CPS-TUS), which is a tobacco survey distributed together with the the Current Population Survey by the US Census Bureau. Users of e-cigarettes were identified from the most recent survey that was conducted in 2014/15, and rates of smoking quitting were obtained from those who had reported smoking cigarettes twelve months before the survey.

E-cigarettes may not be entirely attributed to this though, as national anti-smoking campaigns have made significant strides in promoting smoking cessation.

A total of 65 percent of smokers who used e-cigs within 12 months had attempted to quit smoking traditional cigarettes, compared to 40 percent of smokers who didn't use e-cigs.

Peter Hajek, director of the health and lifestyle research unit at Queen Mary University in London, who wasn't part of the study commented on this finding: "It's absolutely clear that e-cigarettes help smokers replace cigarettes". The new study, published in BMJ medical journal, stands in contrast to previous studies suggesting that using e-cigarettes actually makes it harder to quit.

In practice, Wann said he is fairly tolerant of patients trying e-cigarettes as a means to quit, but he doesn't raise the option or encourage it. Overall, more people quit in the latest year that data was available - the 2014-15 year - than in the 2010-11 year. This does not contain tar, or other chemicals usually found in cigarettes.

Vaping is helping people quit smoking. "Again", Zhu et al. write, "the 2014-15 survey had a noticeably higher overall cessation rate because the e-cigarette user subgroup had a higher cessation rate than those who did not report e-cigarette use in the past year".

Other study limitations included not addressing the long-term effects of e-cigs or investigating if the use of e-cigs leads people to start smoking.

But while the risks of e-cigarettes are still somewhat unclear, some public health experts say the results are promising.

Warner noted that pharmaceutical aids to quit smoking, such as varenicline (Chantix) and bupropion (Zyban), as well as transdermal nicotine patches and other nicotine replacement products, have had no impact on smoking cessation rates on a population level.

In an accompanying editorial, Christopher Bullen, MD, PhD, of the University of Auckland in New Zealand, wrote that the findings have implications for legislators in the US and other countries who are considering how to best regulate e-cigarettes.

"We are pretty confident that e-cigarettes are less risky, but that is only because cigarettes are so bad", he said.

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