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Wolfson Institute of Preventive Medicine - Barts and The London

E-cigarettes more helpful than nicotine replacement treatments for dependent smokers

A randomised trial has shown that e-cigarettes are much more effective than nicotine replacement treatments in achieving long term smoking reduction and cessation in smokers who were previously unable to stop smoking using conventional treatments.

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Around 80% of smokers accessing the current best treatments continue to smoke after a year. In the first study of its kind, 135 smokers received either an eight-week supply of nicotine replacement treatment of their choice, or an e-cigarette starter pack, with instructions to purchase further e-liquids of strength and flavours of their choosing for themselves. Products were accompanied by minimal behavioural support. Researchers from the Wolfson’s Health and Lifestyle Research Unit found a significant difference in smoking reduction (including cessation) in the e-cigarette group versus the nicotine replacement treatment group at six months (27% versus 6%). A large difference was also found in biochemically validated abstinence rates (19% versus 3%).

The results suggest that recommending a refillable e-cigarette with an e-liquid with a strength and flavour of the patient’s choice is a more effective approach for dependent smokers than prescribing nicotine replacement treatment. The e-cigarette starter pack also costs much less than nicotine replacement treatment. Lead author, health psychologist Dr Katie Myers Smith, said: “These results have important clinical implications for smokers who have previously been unable to stop smoking using conventional treatments. E-cigarettes should be recommended to smokers who have previously struggled to quit using other methods, particularly when there is limited behavioural support available.”

This study was funded by Cancer Research UK.

Katie Myers Smith, Anna Phillips-Waller, Francesca Pesola, Hayden McRobbie, Dunja Przulj, Marzena Orzol, Peter Hajek. E-cigarettes versus nicotine replacement treatment as harm reduction interventions for smokers who find quitting difficult: Randomised controlled trial. Addiction 2021