Table of Contents
- INTRODUCTION
- WHAT ARE E-CIGARETTES?
- ARE E-CIGARETTES SAFE?
- DO E-CIGARETTES HELP PEOPLE QUIT SMOKING?
- WHAT WERE THE RESULTS OF THE COCHRANE STUDY ON USING ELECTRONIC CIGARETTES FOR SMOKING CESSATION?
- HOW SHOULD THE RECENT COCHRANE STUDY ON E-CIGARETTES AFFECT PUBLIC HEALTH POLICY?
- LARGEST STUDY TO-DATE FINDS E-CIGARETTES ARE MORE EFFECTIVE FOR QUITTING THAN NRT - CONCLUSION
INTRODUCTION
In a landmark development that promises to reshape strategies for quitting smoking, the latest Cochrane review has delivered compelling evidence: E-Cigarettes reign supreme over traditional nicotine replacement therapy (NRT) in aiding smoking cessation.
This revelation comes as a beacon of hope for millions worldwide struggling to kick the habit, offering a glimmer of clarity amidst the often murky discourse surrounding E-Cigarettes. With its classification of the evidence as "high-certainty," this review commands attention from healthcare professionals, policymakers, and smokers alike, heralding a potential paradigm shift in the approach to smoking cessation.
Join us as we delve into the depths of this groundbreaking review, unpacking its implications and shedding light on the future of smoking cessation efforts.
WHAT ARE E-CIGARETTES?
E-Cigarettes are also known as vaping devices, vapes, or in the scientific community ‘ENDS’ which is an acronym for Electronic Nicotine Delivery Systems. They use a battery and heating element to aerosolise a liquid mixture, called ‘e-liquid’, that contains nicotine. This allows the user to inhale the aerosol, often referred to as ‘vapour’, containing nicotine into their lungs.
The whole point of E-Cigarettes is they don’t contain all the harmful chemicals found in tobacco, and the chemicals made in the process of burning it! It was invented as a harm reduction device, offering a similar way to consume nicotine like smoking but with most of the harm removed.
In fact, Public Health England’s evidence reviews continue to reinforce that E-Cigarettes are at least 95% less harmful than smoking (1). Cancer Research UK conducted their own study on the harm from E-Cigarettes compared with smoking, resulting in the figure of about 97% less harmful – so pretty close to Public Health England’s figure.
This elimination of most of the harm from smoking, along with the inhaling nature that forms part of the smoking habit, puts E-Cigarettes in a prime position to help people quit tobacco.
ARE E-CIGARETTES SAFE?
E-Cigarettes are a relatively new product, so more long-term studies need to be done, however we often see attention-grabbing headlines talking about ‘harms from vaping’ – like one from the Daily Mail recently that suggested a new study indicated that E-Cigarettes could cause cancer.
The sad reality is that these headlines are often untrue, and the one from the Daily Mail was the same. The harms we have seen from E-Cigarettes are mainly in the United States, where a complete lack of regulation regarding flavourings used, as well as the addition of THC (the psychoactive ingredient in cannabis) by means of a chemical called ‘vitamin E acetate’ have caused trouble. (2)
In the UK, E-Cigarettes are regulated by the Medicines and Healthcare Regulatory Authority (MHRA) to ensure the highest standards are met, and that flavourings known to be harmful when inhaled are prohibited. The lack of oversight in the United States bred problems like the inclusion of diacetyl as a flavouring, a chemical used to flavour popcorn that popcorn factory workers inhaled and caused the disease known as ‘popcorn lung’.
Vitamin E acetate has been used as an additive to mix THC into e-liquid in the United States, causing lung damage, named EVALI (E-Cigarette and Vaping Associated Lung Injury). All instances of EVALI were found to have vitamin E acetate in the lung samples.
E-liquids made and regulated for retail in the UK, like us at SMOKO, do not have these issues, making UK made e-liquids the safest around. So, in order to vape safely in the long term, looking after your device with the appropriate maintenance and storing it properly for transport are the big concerns for vaping safely in the UK.
DO E-CIGARETTES HELP PEOPLE QUIT SMOKING?
Study after study, E-Cigarettes come out on top as the best way to quit smoking.
Early studies compared E-Cigarette use against nicotine replacement products, including nicotine patches and nicotine gum, with results favouring E-Cigarettes.
Despite these studies, vaping has been met with resistance. Interestingly, Action on Smoking and Health conducted a study that found about 40% of smokers think that vaping is as harmful or worse than smoking! This is likely down to the headlines scaring people with reports of vaping harms in the U.S that we have already mentioned can be attributed to vitamin E acetate.
The largest study conducted to date on the effectiveness of E-Cigarettes for quitting smoking was recently conducted by the Cochrane Collaboration – a non-profit organisation that aims to help people make decisions about health. Cochrane are renowned for high quality studies that follow a common methodology to limit bias and random error.
WHAT WERE THE RESULTS OF THE COCHRANE STUDY ON USING ELECTRONIC CIGARETTES FOR SMOKING CESSATION?
The Cochrane study on the effectiveness of E-Cigarettes for quitting smoking included 88 complete studies, over half of which were randomised controlled trials. The study found high certainty evidence in 7 studies that indicated E-Cigarettes may improve quit rates by an additional 4 quitters per 100. (3)
They found moderate certainty evidence that nicotine E-Cigarettes increase quit rates compared to non-nicotine E-Cigarettes in 6 studies, translating to an increase in the number of quitters by 3 per 100.
Low-certainty evidence was found that quit rates may be higher for E-Cigarettes compared with behavioural support only and no support at all in 9 studies. This low-certainty evidence is due to the risk of bias identified in these studies but still indicated a potential increase of the number of quitters by 4 per 100.
The conclusions drawn by the authors of the study were that there is high-certainty evidence that nicotine E-Cigarettes increase quit rates compared to nicotine replacement therapy, and moderate-certainty evidence that nicotine E-Cigarettes increase quit rates compared to nicotine-free E-Cigarettes.
The study also concluded by saying that the evidence comparing nicotine-free E-Cigarettes with those containing nicotine is suggestive of improved outcomes (i.e. quitting smoking) but that this conclusion is less certain due to the risk of bias.
As an addition, the incidence of serious adverse events was low across all studies, and the authors did not detect evidence of serious harm from adverse events from nicotine E-Cigarettes, though the number of long-term studies was small, with a maximum follow up of 2 years.
HOW SHOULD THE RECENT COCHRANE STUDY ON E-CIGARETTES AFFECT PUBLIC HEALTH POLICY?
While the numbers may seem small, talking about an extra 3 to 4 quitters per 100, this statistically significant improvement in quit rates shouldn’t be ignored. To put the numbers in perspective, there are about 6.4 million smokers in the UK according to Action on Smoking and Health (4) – so, if all the smokers were to try and quit smoking at the same time, we could see an additional 192,000 to 256,000 smokers becoming smoke-free!
Given that number of self-reported quitters for 2021/2022 was 97,654 – about 1.5% of the total smokers in the UK – the use of E-Cigarettes could see this number increase by almost 2,929 to 3,906 – and that’s just the self-reported quitters according to the NHS! (5)
LARGEST STUDY TO-DATE FINDS E-CIGARETTES ARE MORE EFFECTIVE FOR QUITTING THAN NRT - CONCLUSION
The numbers are in, and things are looking up for quitters. The study results translate to around a 3 to 4% increase in the number of people successfully quitting smoking with nicotine E-Cigarettes. This may not seem huge, however it is statistically significant and could translate to thousands of additional UK smokers kicking the habit.
Cancer Research UK and Public Health England found that E-Cigarettes are at least 95% less harmful than traditional cigarettes, however ASH conducted a study that found around 40% of smokers believe that E-Cigarettes are as harmful or even worse than smoking! (6) This means there is still work to be done, increasing the awareness of smokers on the risk of E-Cigarettes compared with smoking, and the benefits of using vaping to quit smoking.
If you are a smoker looking to quit, then check out our starter kit deals and make the switch with SMOKO today and give yourself the best chance of quitting cigarettes for good!
REFERENCES
1) E-cigarettes: an evidence update A report commissioned by Public Health England
2) E-Cigarette or vaping product, use associated lung injury (EVALI)
3) Electronic cigarettes for smoking cessation
4) Number of smokers in the UK
6) Expert reaction to latest results from ASH annual survey
ABOUT THE AUTHOR
Written by Dan Overgage
Dan Overgage is a former smoker of 10 years until he became a client of SMOKO E-Cigarettes. Dan started working with SMOKO 5 years ago after successfully quitting using our e-cigarettes and works across our Customer Service and heads up our content creation and research with a strong focus on all things quitting smoking. During his tenure with SMOKO, Dan has written countless blogs and consults with countless clients every day to help them to stay smoke-free.
