Vaping Twice as Effective as Patches for Quitting

Published on January 30, 2019

A yearlong, randomized trial in England showed that e-cigarettes were almost twice as successful as products like patches or gum for smoking cessation.

It has been one of the most pressing unanswered questions in public health: Do e-cigarettes actually help smokers quit? Now, the first, large rigorous assessment offers an unequivocal answer: yes.

The study, published Wednesday in the New England Journal of Medicine, found that e-cigarettes were nearly twice as effective as conventional nicotine replacement products, like patches and gum, for quitting smoking.

The success rate was still low — 18 percent among the e-cigarette group, compared to 9.9 percent among those using traditional nicotine replacement therapy — but many researchers who study tobacco and nicotine said it gave them the clear evidence they had been looking for.

“This is a seminal study,” said Dr. Neal L. Benowitz, chief of clinical pharmacology at the University of California, San Francisco, an expert in nicotine absorption and tobacco-related illnesses, who was not involved in the project. “It is so important to the field.”

The study was conducted in Britain and funded by the National Institute for Health Research and Cancer Research UK. For a year, it followed 886 smokers assigned randomly to use either e-cigarettes or traditional nicotine replacement therapies. Both groups also participated in at least four weekly counseling sessions, an element regarded as critical for success.

The findings could give some new legitimacy to e-cigarette companies like Juul, which have been under fire from the government and the public for contributing to what the Food and Drug Administration has called an epidemic of vaping among teenagers. But they could also exacerbate the difficulty of keeping the devices away from young people who have never smoked while making them available for clinical use.

“There is an unavoidable tension between protecting kids from e-cigarettes and smoking cessation, which is also very important,” Dr. Benowitz said.

Tobacco use causes nearly 6 million deaths worldwide each year, including 480,000 in the United States, according to the Centers for Disease Control and Prevention. If tobacco use trends continue, the global death tally is projected to reach 8 million deaths annually by 2030.

E-cigarettes provide the nicotine smokers crave without the toxic tar and carcinogens that come from inhaling burning tobacco. But regulators in the United States, Britain and elsewhere have not approved them to be marketed as smoking cessation tools.