Years ago, a book titled It’s Easy to Quit Smoking, If You Know How, was popularized, but judging by the number of people who want to quit smoking and can’t, it shouldn’t be as simple as its author, the book writer, postulated. by Allen Carr. When e-cigarettes first came on the market, many smokers thought they could serve as a temporary aid to breaking their addiction, but there has been a lot of research into the pros and cons of using them as smoking cessation therapy, and Health professionals have warned about the health risks of these devices.
Now, however, new work has found that adding the use of e-cigarettes to standard smoking cessation counseling is helpful because it led to greater abstinence from tobacco use among smokers than smoking cessation counseling alone. only. This is the largest global study on this topic, involving researchers from the fields of family medicine, pulmonology, toxicology, addiction medicine and epidemiology at five study centers in Switzerland (Bern, Geneva, Lausanne, Zurich, St. Gallen), and has been led by the University of Bern (Switzerland).
Vapers, which are also known as electronic cigarettes, or electronic nicotine delivery systems (SEANS), are electrical devices that emit nicotine in vapor form. They do not contain tobacco and their levels of toxic compounds are significantly lower than those contained in traditional cigarettes.
Researchers compared the effectiveness, safety, and toxicity of vapes as part of intensive smoking cessation counseling compared to intensive smoking cessation counseling without vapes. Smoking cessation counseling in both groups included intensive behavioral support as well as recommendations for the use of smoking cessation medications and nicotine replacement therapy.
The results have been published in The New England Journal of Medicine and show that vapes are more effective in quitting smoking than conventional smoking cessation advice without vapes, and have few side effects. However, they do not help eliminate nicotine dependence.
“Our study confirms previous findings that vapes are effective in quitting tobacco smoking. It also shows the benefits they provide in the context of intensive counseling to quit smoking, as we do in Switzerland,” says Reto Auer, study leader at the Institute of Primary Health. Care (BIHAM) of the University of Bern and Unisanté, University Center for Primary Care and Public Health of Lausanne.
Quit tobacco and then quit vapes and, therefore, nicotine
A total of 1,246 participants from the two groups were surveyed and clinically examined over six months at the five study centers in German and French Switzerland. Health-related adverse events were recorded in detail. The results showed that adding vapes to intensive smoking cessation counseling increased abstinence from tobacco smoking by 21%.
The smoking abstinence rate was 53% in the vaping group and 32% in the non-vaping group (67% higher abstinence with vaping compared to non-vaping). However, many people who stopped smoking tobacco continued using vapes and, therefore, with nicotine, so nicotine withdrawal was lower in this group. The difference was 14% (20% nicotine withdrawal in the vaping group compared to 34% in the non-vaping group).
The smoking abstinence rate was 53% in the vaping group and 32% in the non-vaping group, but many people who quit smoking tobacco continued to use nicotine vapes.
Regarding side effects, no serious adverse events occurred more frequently in the group with vapers than in the group without vapers. “This evidences the safety of vapers in smoking cessation counseling in light of the large scope of the study,” says Auer. On the other hand, milder side effects were found, such as respiratory tract irritation. “This can be explained, among other things, by the fact that the nicotine from vapes irritates the throat more than conventional cigarettes, which contain additives to alleviate precisely these symptoms,” explains Auer.
Health problems such as cough and sputum production were lower in the vaping group than in the control group (41% fewer participants reported cough compared to 34%). “Cough and sputum production are typical symptoms of a smoker’s lung. A reduction in these symptoms could indicate that smokers who completely switch to vapes and stop smoking tobacco could suffer fewer tobacco-related diseases in the long term, even if they continue using vapes,” explains Martin Brutsche, pulmonologist and director of the study center. from St. Gallen.
However, according to researchers, long-term studies are needed to confirm the health benefits compared to continuing smoking. “The majority of smoking-related diseases are caused by toxic and carcinogenic substances in tobacco, and not by nicotine,” continues Martin Brutsche.
“Most smokers want to quit smoking tobacco cigarettes, but many cannot do so even with available, established and scientifically proven smoking cessation products. This is where vapers could help as part of smoking cessation counseling,” says Isabelle Jacot-Sadowski, who participated in the Lausanne think tank. “By using vapes, smokers could reduce their risk of tobacco-related diseases until they later decide to stop using nicotine completely,” she adds. Vapes therefore allow for a pragmatic two-stage approach: first quitting tobacco and then quitting vapes and therefore nicotine.
Vapes are not risk-free
Although vapes emit much fewer toxic substances than tobacco cigarettes, they also release carcinogenic substances and nicotine can cause addiction, especially among young people, in many Western countries a sharp increase in vaping among young people is observed with concern. “Teens and non-smokers should breathe fresh air instead of vaping. That is why it is important to ensure that access to vapers is sufficiently regulated,” says Auer.
The researchers have stressed that the study only examined vaping use in people willing to quit smoking and enrolled in smoking cessation counseling. “We therefore advocate that the use of vapes can be recommended to smokers as part of smoking cessation counselling, but that non-smokers should not have easy access to vapes, tobacco cigarettes or other products. that contain nicotine,” concludes Auer.
Josep Maria Suelves, head of the Smoking and Injury Prevention and Control Service at the Public Health Agency of Catalonia and member of the Board of Directors of the National Committee for the Prevention of Smoking, also warns, in statements to SMC Spain, of the risks associated with the use of electronic cigarettes: “A high proportion of smokers who quit tobacco continue to regularly use electronic cigarettes with nicotine after six months, unlike what usually happens in therapy with nicotine-containing medications, where the Pharmacological treatment is withdrawn before reaching that time. Thus, the potential help of electronic cigarettes to quit smoking contrasts with the risks of their continued use in terms of potential relapse or the long-term harmful effects of nicotine and other toxic components of the aerosols emitted by these devices. ”.
“In addition, even in the case of smoking cessation medications, it is difficult for the benefits obtained under the demanding conditions of a clinical trial to also be observed in real-life conditions, in which many smokers present more complex clinical situations.” and they cannot access intense professional support.”
