Electronic Cigarettes or the Patch?

Electronic cigarettes with nicotine just as effective as nicotine patch for quitting smoking

(RxWiki News) Electronic cigarettes have become very popular lately. But will they help you quit smoking?

A recent study was conducted to see if electronic cigarettes (e-cigs) with nicotine were more effective than nicotine patches in helping smokers quit.

The researchers found that e-cigs with nicotine helped more of the participants quit during a six-month period than the patch did. E-cigs were not found in this study to have any more negative side effects than the patch.

However, the authors discovered that fewer people quit than they initially expected, so they could not determine if e-cigs were actually better than the patch. The authors concluded that e-cigs might be more effective than nicotine patches to quit smoking, but more research is needed.

"Talk to your doctor about how to quit smoking."

The lead author of this study was Christopher Bullen, MBChB (Bachelor of Medicine and Bachelor of Surgery), from the National Institute for Health Innovation in the School of Population Health at the University of Auckland in Auckland, New Zealand.

The researchers used ads in community newspapers to recruit participants.

The participants had to be 18 years or older, have smoked at least 10 cigarettes per day for the past year and wanted to quit smoking. The researchers excluded anyone who was pregnant or breastfeeding, already using a method to quit smoking or had reported stroke, heart attack, medical disorders or chemical dependence.

The researchers selected 657 participants and randomly assigned them to one of three groups. There were 289 people in the nicotine e-cigarette group, 295 people in the nicotine patches group and 73 people in the placebo (no nicotine) e-cigarettes group.

The participants were then followed-up at one month, three months and six months past the initial quit date.

The researchers used a carbon monoxide breath test to determine if smokers had actually quit (continuous verified abstinence).

After six months, the researchers found that 7 percent (21 out of 289) of the nicotine e-cigarette group, 6 percent (17 out of 295) of the patches group and 4 percent (3 out of 73) of the placebo e-cigarette group had verified continuous abstinence.

Most of the participants relapsed within 50 days. In the nicotine e-cig group, the average relapse time was 35 days — twice as long as the average relapse times for either the patch (14 days) or placebo (12 days) group.

Of the nicotine e-cig group, 57 percent had reduced their daily cigarette count by at least half at the six-month mark. Only 41 percent of the patch group was able to decrease their daily cigarettes by half.

In general, the nicotine e-cig group was able to stick with their quitting method more and longer than the other two groups.

Overall, the researchers discovered that the achievement of abstinence was much lower than they had anticipated, and therefore they believe that there was not enough data to determine what method was most effective overall.

The authors noted multiple limitations of their study.

First, the initial estimates of abstinence were too high, so the participant population wasn't big enough to definitively determine which method was the most effective. Second, the nicotine patch group lost more people in follow-up and due to withdrawal from the study than the other two groups. Third, the study period lasted a short period of time.

The researchers suggested a need for a longer, more detailed study with a bigger population.

This study was published online ahead-of-print in the September edition of The Lancet.

The Health Research Council of New Zealand provided funding.

Review Date: 
September 11, 2013