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Success in the ENDS

Canadian research confirms efficacy of vaping as a means to smoking cessation.

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A team from the University of Manitoba set out to answer the question: “Are electronic nicotine delivery systems an effective smoking cessation tool?” In order to find a conclusion they analysed randomized control trials (RCT) held on the PubMed, Scopus and Web of Science Core Collection databases.

The respected research team consisted of Christine Lam and Andrew West, who both work at the Department of Respiratory Therapy in Winnipeg and have a vast number of peer-reviewed papers to their names. Noting that electronic nicotine delivery systems (ENDS) have become hugely popular they decided that an analysis of efficacy was appropriate.

We have covered many of the previous studies and expert pronouncements on the topic of efficacy here. The overwhelming majority have all fallen on the side of vaping as a successful and popular route to quit smoking.

They note that fears surrounding vaping, and that the majority of sales are completed over the internet has led some to call for stringent controls to be put in place. This is balanced by them observing that the consumer-led success of ecigs is what has contributed to their public health success. They wrote: “Given the controversy regarding the impact of the use of ENDS, the objective of the present systematic review was to determine whether ENDS constitute an effective smoking cessation tool. Moreover, the present review sought to determine whether ENDS should be considered as a possible adjunct to aid in smoking cessation.”

Focussing only on randomized control trials was important, as it is only those that appraise the effectiveness of vaping as a quit route. All studies were appraised for the potential of bias to dictate the outcomes – ensuring that the conclusion is something that can be relied upon. This included sources of research funding and things like “proper treatment blinding technique mitigating influences that would impact data outcomes.”

From the 109 papers they excluded 22 for being duplicates, 74 for not being relevant and 7 for not using an RCT design. Of the remaining, just four passed the risk of bias evaluation.

“No serious adverse events (eg, deaths or events requiring hospitalization) were reported by any of the included publications,” which is fortunate! They identified drawbacks of the studies in question: “Outcome measures were self-reported; thus, participants may have recalled positive memories more than negative ones, thereby favouring the results of the study, although most self-report was verified by measuring eCO level. Similarly, all four studies used some form of a survey or questionnaire to measure baseline values, desire to smoke and withdrawal symptoms. Surveys and questionnaires offer limitations where it is unknown whether participants were able to interpret the questions as intended or whether participants answered questions truthfully.”

So, what did they conclude?

  • “ENDS may constitute an effective smoking cessation tool.”
  • The studies found that vaping reduced smoking, led to smoking abstinence, reduced or removed the desire to smoke and reduced or removed level of withdrawal symptoms.
  • Success was achieved even though “a majority of the studies reported in the present review included participants that initially had no desire to quit smoking.”
  • “ENDS have the potential to eliminate the harmful effects of tobacco smoking.”
Dave Cross avatar

Dave Cross

Journalist at POTV
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Dave is a freelance writer; with articles on music, motorbikes, football, pop-science, vaping and tobacco harm reduction in Sounds, Melody Maker, UBG, AWoL, Bike, When Saturday Comes, Vape News Magazine, and syndicated across the Johnston Press group. He was published in an anthology of “Greatest Football Writing”, but still believes this was a mistake. Dave contributes sketches to comedy shows and used to co-host a radio sketch show. He’s worked with numerous vape companies to develop content for their websites.

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