‘E-cigarettes, nicotine patches help kick butt’

The first ever clinical trial to compare e-cigarettes with nicotine patches has found that both methods help to kick the butt. According to a study published in the Lancet, similar proportions of smokers who used either method remained abstinent from smoking for six months after a 13 week course of patches or e-cigarettes.

The study due to be presented at the European Respiratory Society (ERS) Annual Congress 2013 in Barcelona, Spain, is only the second controlled trial to be published which evaluates e-cigarettes, and is the first ever trial to assess whether e-cigarettes are more or less effective than an established smoking cessation aid, nicotine patches, in helping smokers to quit.
Led by associate professor Chris Bullen, director of the National Institute for Health Innovation at the University of Auckland in New Zealand, a team of researchers recruited 657 smokers to the trial through adverts in local newspapers. Study participants were all people who wanted to quit smoking and were divided into three groups: just under 300 (292) received 13 weeks’ supply of commercially available e-cigarettes, each of which contained around 16mg nicotine. The same number (292) received 13 weeks’ supply of nicotine patches, and a smaller number of participants (73) received placebo e-cigarettes, which contained no nicotine.
Over 13 weeks of using the cessation aids and three months further follow-up, participants underwent testing to establish whether they had managed to remain abstinent from cigarettes. At the end of the six-month study period, around one in 20 study participants (overall, 5.7%) had managed to remain completely abstinent from smoking. 
While the proportion of participants who successfully quit was highest in the e-cigarettes group (7.3%, compared to 5.8% for those in the nicotine patches group, and 4.1% in the placebo e-cigarettes group), these differences were not statistically significant. The results suggest that e-cigarettes are comparable to nicotine patches in helping people to quit for at least six months. “While our results don’t show any clear-cut differences between e-cigarettes and patches in terms of quit success after six months, it certainly seems that e-cigarettes were more effective in helping smokers who didn’t quit to cut down,” says Prof. Bullen.
Writing in a linked comment, Prof. Peter Hajek, director of the Tobacco Dependence Research Unit at the Wolfson Institute of Preventive Medicine, Queen Mary University of London, UK, says, “This is a pioneering study which has generated new and useful information. The key message is that in the context of minimum support, e-cigarettes are at least as effective as nicotine patches. E-cigarettes are also more attractive than patches to many smokers, and can be accessed in most countries without the restrictions around medicines that apply to nicotine replacement therapy or the costly involvement of health professionals. These advantages suggest that e-cigarettes have the potential to increase rates of smoking cessation and reduce costs to quitters and to health services.”

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