People attempting to quit smoking without professional help are approximately 60% more likely to report succeeding if they use e-cigarettes than if they use willpower alone or over-the-counter nicotine replacement therapies such as patches or gum, finds a large UCL (University College London) survey of smokers in England. (1) The results were adjusted for a wide range of factors that might influence success at quitting, including age, nicotine dependence, previous quit attempts, and whether quitting was gradual or abrupt.
The study, published in Addiction, surveyed 5,863 smokers between 2009 and 2014 who had attempted to quit smoking without the aid of prescription medication or professional support. 20% of people trying to quit with the aid of e-cigarettes reported having stopped smoking conventional cigarettes at the time of the survey.
The research, chiefly funded by Cancer Research UK, suggests that e-cigarettes could play a positive role in reducing smoking rates. "E-cigarettes could substantially improve public health because of their widespread appeal and the huge health gains associated with stopping smoking," says Professor Robert West of UCL's Department of Epidemiology & Public Health, senior author of the study. "However, we should also recognise that the strongest evidence remains for use of the NHS stop-smoking services. These almost triple a smoker's odds of successfully quitting compared with going it alone or relying on over-the-counter products." (2)
Another survey by the same team found that most e-cigarette use involves first generation 'cigalike' products rather than second generation ones that use refillable cartridges and a wider choice of nicotine concentrations and flavors. (3) Dr Jamie Brown of UCL's Department of Clinical, Educational and Health Psychology, lead author of both reports, says: "We will continue to monitor success rates in people using e-cigarettes to stop smoking to see whether there are improvements as the devices become more advanced."
Some e-cigarette users may want to continue using them indefinitely. "It is not clear whether long-term use of e-cigarettes carries health risks but from what is known about the contents of the vapour these will be much less than from smoking," says Professor West.
"Some public health experts have expressed concern that widespread use of e-cigarettes could 're-normalise' smoking. However, we are tracking this very closely and see no evidence of it. Smoking rates in England are declining, quitting rates are increasing and regular e-cigarette use among never smokers is negligible." (4)
Notes to Editors
Information about the free services provided by the NHS to help people stop smoking can be found at the following URL: http://www.nhs.uk/smokefree
Professor West is author of a new guide to stopping smoking called The SmokeFree Formula (Orion Books). See http://www.smokefreeformula.com for more information.
1) Brown, Beard, Kotz, Michie & West, 'Real-world effectiveness of e-cigarettes when used to aid smoking cessation: a cross-sectional population study', will be published in Addiction on Wednesday 21 May at 00:01 London time / Tuesday 20 May at 19:01 US Eastern time.
2) The previous study investigating the effectiveness of NHS services is as follows: Kotz, Brown & West, 'Real-world effectiveness of smoking cessation treatments: a population study', published in Addiction on 20 December 2013: http://dx.doi.org/10.1111/add.12429 , which was in line with meta-analysis of a large number of randomised controlled trials: Stead LF, Lancaster T. 'Combined pharmacotherapy and behavioural interventions for smoking cessation.' Cochrane Database of Systematic Reviews. 2012;10:CD008286: http://dx.doi.org/10.1002/14651858.CD008286.pub2
3) The 2012 survey on e-cigarette usage is: Brown, West, Beard, Michie, Shahab & McNeill, 'Prevalence and characteristics of e-cigarette users in Great Britain: Findings from a general population survey of smokers', published in Addictive Behaviours on 11 March 2014: http://dx.doi.org/10.1016/j.addbeh.2014.03.009
4) The data for the study come from The Smoking Toolkit Study which tracks smoking habits in adults over the age of 16 every month and publishes the results online at http://www.smokinginengland.info/latest-statistics/ Each month a new sample of approximately 1800 adults are selected using a form of random location sampling and complete a face-to-face computer-assisted survey with a trained interviewer. The method has been shown to result in a sample that is nationally representative in its socio-demographic composition and proportion of smokers.
The Smoking Toolkit Study is currently funded by Cancer Research UK. Since its inception it has also been co-funded at various times by The Department of Health, Pfizer, Glaxo-SmithKline and J&J (who manufacture stop-smoking medicines and nicotine replacement therapy but not e-cigarettes). Jamie Brown's salary is funded by The Society for the Study of Addiction. Robert West's salary is funded by Cancer Research UK. The study team has not received, and has a policy of not accepting, funding from any e-cigarette manufacturers.
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