“Few topics in public health and medicine are as contentious as electronic cigarettes (e-cigarettes), a diverse and rapidly evolving array of products that appeared on the consumer market a decade ago,” says Rigotti.
At the beginning of the year, AMA President Patrice Harris was decrying a ban on pod flavours not going far enough: “The new policy to address the youth e-cigarette epidemic by limiting flavours in some vaping products is a step in the right direction but does not go far enough. The AMA is disappointed that menthol flavours - one of the most popular - will still be allowed, and that flavoured e-liquids will remain on the market, leaving young people with easy access to alternative flavoured e-cigarette products.” [link]
Against this backdrop, it is vital the AMA’s members are educated in facts and evidence rather than emotive bluster.
“When used temporarily, e-cigarettes could be cessation aids, whereas when used long- term, these products could be harm-reduction tools. Either way, individual smokers could benefit because use of e-cigarettes is likely to have a substantially lower health risk than continuing to smoke cigarettes,” highlights Dr Rigotti.
“Recent large randomized trials in England and New Zealand have begun to fill the evidence gap. In the trial from England, which included 886 participants who smoked cigarettes, use of e-cigarettes increased the rate of sustained cigarette abstinence at 1 year compared with nicotine replacement therapy (NRT), with quit rates of 18.0% vs 9.9%.”
Referring to the New Zealand trial, Rigotti points out that the results showed a 2% success rate for traditional NRT products in keeping smokers off tobacco – whereas vaping products achieved a success rate of 7%.
Pointing to a third study, Rigotti tells AMA members that counselling alone achieved a 9.9% success quit rate after 6 months yet counselling plus vaping achieved 17.2%. The argument for vaping’s efficacy is being proven time after time.
“The Cochrane review concluded that ‘moderate certainty evidence’ supports the effectiveness of nicotine-containing e-cigarettes to aid cessation when compared with non-nicotine e-cigarettes and NRT,” she adds.
The success shown in studies, she argues, is probably not reflective of the real world achievements as vape products have developed to be better than the versions currently used in research. One study, she notes, had to drastically alter its methodology due to the old products they planned to use going out of stock midway through the trial.
“In summary, the accumulating evidence from clinical trials suggests that e-cigarettes will likely turn out to be safe and effective tools to aid smoking cessation. However, as with all existing smoking cessation therapies, e-cigarettes are not the single or long-sought-after solution to help all or even most smokers to quit.
“High-quality data from rigorously conducted trials are needed to know whether or how much e-cigarettes might help the 34 million US residents who still smoke cigarettes, many of them in vulnerable and disadvantaged groups, to avoid a bleak future of disease, disability, and death related to tobacco smoking.”
- “Randomized Trials of e-Cigarettes for Smoking Cessation” by Nancy A. Rigotti – [link]