New study adds more smoke to the vaping debate

By Dr Joe Milton the Australian Science Media Centre

Smokers undergoing counselling to quit smoking are more likely to succeed if nicotine vapes are part of the strategy, according to an international study published in the New England Journal of Medicine this week.

As Australia gears up to make vaping prescription-only from March, fierce debate has raged over whether vapes are a menace creating a new generation of nicotine addicts, or a lifesaver for smokers who are trying to quit.

The government is hoping the changes to the law will make it harder for kids to get hold of vapes, while they’ll remain available as a cessation aid for adult smokers via their doctors.

The new study suggests vapes may have an important role to play in helping people get off the smokes. 

The researchers recruited 1,246 smokers, 622 of whom received counselling along with free e-cigarettes and e-liquids. The other 624 underwent counselling but were given a voucher to spend on anything they liked, instead of the free e-cigarettes.

Six months on, around three in five smokers in the vaping group had stayed off the smokes in the week before their check-up, compared to around two in five among the other group.

Dr Colin Mendelsohn, a retired academic, researcher, and smoking cessation clinician, says the study was “large” and “well-conducted” and that the results “support the use of vaping nicotine as an effective quit-smoking aid.”

“After six months, 28.9% of smokers in the intervention group were continuously abstinent from the quit date compared to 16.3% in the control group,” he said. And, perhaps surprisingly, “respiratory symptoms improved in the intervention group to a larger extent than for subjects in the control [non-vaping] group,” he added.

Vaping crackdown divides scientists

So far, so promising, but the study did not look at how vaping compared to other available smoking cessation methods, including nicotine replacement therapy, said Associate Professor Michelle Jongenelis from The University of Melbourne.

And vapes should not be considered completely harmless as e-liquids can contain potentially damaging chemicals, she added.

(For a wider discussion and some dissenting views listen to Cosmos new podcast series “Debunks: Vaping – below)

When it came to who had kicked the nicotine habit altogether, the news was also not so good for the vapers. Only around one in five people in the vaping group had given up all nicotine products completely, compared to one in three for the other group, suggesting many of those who gave up smoking tobacco continued using e-cigarettes.

“It is critical that those who use e-cigarettes to quit smoking are then supported to quit the use of e-cigarettes… ongoing use is not recommended,” said Associate Professor Jongenelis

But Dr Mendelsohn said the study suggests “vaping nicotine is an effective quitting aid with a good safety profile.”

“Australian doctors should feel more confident in prescribing vaping products for their smoking patients, especially those unable to quit with other methods.” 

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