Important new evidence that using e-cigarettes reduces successful quitting cigarettes

A new paper adds to the growing evidence that claims that e-cigarettes help people quit smoking are false.

Katrina Vickerman and colleagues collected information on e-cigarette use from people who called state quitlines in Connecticut, Louisiana, Nebraska, North Carolina, South Carolina, and Texas.  Nearly one third (30.9%) of respondents reported ever using or trying e-cigarettes; most used for a short period of time
(61.7% for less than 1 month). Consistent with what other surveys have found, the most frequently reported reasons for use were to help quit other tobacco (51.3%) or to replace other tobacco products (15.2%).

Most important, both e-cigarette user groups were significantly less likely to have quit smoking 7 months after first calling the quitline compared with participants who had never tried e-cigarettes: Only 21.7% of people who used e-cigarettes to help quit and 16.6% of those who used e-cigarettes to replace other tobacco products had quit compares to 31.3% of people who did not use e-cigarettes (p < .001).

The other large longitudinal study (from 4 countries) showed most adult smokers who used e-cigarettes were using them to quit, but that e-cigarette users were no more likely to have quit conventional cigarettes than non-e-cigarette users.

This new paper is particularly valuable because it is population based and assesses actual use and behavior patterns in the real world.

The implications of these two papers are clear:

1. Health advocates and physicians (including former Surgeon General Richard Carmona) should stop making and supporting claims that e-cigarettes help people quit smoking.

2. The media should stop uncritically reporting claims that e-cigarettes help people quit smoking.

3. State legislatures should stop considering laws that give e-cigarettes preferential tax and other treatment on the grounds that they "reduce harm."  Such assertions remain as unproven as the assertion that e-cigarettes help people quit smoking conventional cigarettes.

3. The FDA should use its existing authority to prohibit unsupported therapeutic claims that e-cigarettes help people quit.  As I have noted before, the FDA already has the authority (and responsibility) to do this and this particular authority has already been upheld in court.  There is no excuse for continued inaction.

The citation for the new paper is:,Vickerman, et al.  Use of Electronic Cigarettes Among State Tobacco Cessation Quitline Callers. Nicotine & Tobacco Research (2013) doi: 10.1093/ntr/ntt061 [First published online: May 8, 2013]  Link

Comments

? on summary

I have a question about this: "2. The media should stop uncritically reporting claims that e-cigarettes help people smoke."

Thanks for your reporting on this blog!

Longitudinal study

The longitudinal study concluded the opposite of what you state - "ENDS may have the potential to serve as a cessation aid."

The data show no effect of e-cigs on quitting

The statement the commentor quotes says that e-cigs may have potential as a cessation aid, not that they do work as a cessation aid. I was surprised that the authors of the paper in question even said this given that their own data show no effect -- not even a suggestion of an effect (since p=.516) -- on actual cessation. That is the key point in the paper.

The data was on people who already failed quitting

The study was based on people who failed quitting using e-cigarettes before calling a quit line. Are most cessation studies done this way?

The study design was fine

There are many ways to study the effects of different interventions on quitting.  The way that this study was done was fine.