Halpern, Harhay, Saulsgiver, Brophy, Troxel, and Volpp set out to discover “whether financial incentives, pharmacologic therapies, and electronic cigarettes promote smoking cessation among unselected smokers”.
They write: “We randomly assigned smokers employed by 54 companies to one of four smoking-cessation interventions or to usual care. Usual care consisted of access to information regarding the benefits of smoking cessation and to a motivational text-messaging service.”
So far so good.
The four interventions tested:
- Free cessation aids (NRT products or quit medicine, plus ecigs NRT/pills failed)
- Free e-cigarettes, without a requirement that standard therapies had been tried
- Free cessation aids plus $600 in rewards for sustained abstinence
- Free cessation aids plus $600 that could be taken back if the smokers didn’t remain quitters for six months.
The team claim to have discovered that from 6,006 subjects, “sustained abstinence rates through 6 months were 0.1% in the usual-care group, 0.5% in the free cessation aids group, 1.0% in the free e-cigarettes group, 2.0% in the rewards group, and 2.9% in the redeemable deposit group”.
This all seems very clear cut and supports the team in stating that offering financial incentives was more successful than smokers being able to vape – even if vaping was twice as successful as the traditional quit products.
The team gleefully state that their work has “several strengths”. This might be good news for employers looking to help employees quit smoking, the NEJM having another opportunity to bash vaping – or maybe offering Simon Chapman and Stanton Glantz something else to tweet about?
What is clear is the single, very major flaw in the entire proceedings: vaping works when the smoker can successfully substitute cigarettes for something that delivers nicotine successfully.
Poor quality, out-dated products haven’t worked for smokers - the research team used cigalikes, a poor nicotine delivery vehicle to begin with, that contained just 10-15mg of nicotine, an insufficient level for long-term smokers using this type of device.
No doubt this study will go on to be quoted, but its glaring error means that they found out nothing regarding the efficacy of vaping products – just that poor cigalikes as twice as good for quitters than traditional Pharma nicotine replacement products.