E-cigarette users may struggle to quit smoking
Overall, 28% participants occasionally used e-cigarettes within 3 months after discharge from hospital
Researchers tested two smoking cessation approaches for 1,357 adult smokers who were hospitalized and expressed a desire to quit. Patients were randomly assigned to receive a free supply of an approved smoking cessation aid or to join a control group that could call a phone hotline for cessation advice.
Overall, 28 per cent of participants occasionally used e-cigarettes within three months after discharge.
Six months after they left the hospital, about 10 per cent of people who reported using e-cigarettes over the first three months after discharge had successfully quit smoking traditional cigarettes, compared with 27 per cent of those not using e-cigarettes, lab tests found.
There is strong evidence that using these treatments, combined with behavioural support, makes it significantly more likely that smokers will be able to achieve long-term abstinence from tobacco.- Robert Reid
"The study is consistent with the hypothesis that smokers need to use e-cigarettes regularly and daily and switch completely from cigarettes to e-cigarettes for them to have the greatest chance of help," Rigotti, who has received research funding from Pfizer, maker of the smoking-cessation drug Chantix, said by email.
The battery-powered gadgets feature a glowing tip and a heating element that turns liquid nicotine and flavourings into a cloud of vapour that users inhale.
A big question about e-cigarettes, namely, whether they're safe or at least safer than traditional cigarettes, isn't answered by the current study.
Smoking in patients with heart problems
For this study, researchers randomly assigned 302 smokers hospitalized with heart problems to receive either varenicline (Chantix) or a placebo pill for 12 weeks, in addition to counselling.
One year later, lab tests showed that about 40 per cent of the participants quit smoking with varenicline, compared with 29 per cent with placebo, researchers report in the Canadian Medical Association Journal.
While some previous research has linked varenicline to an increased risk of heart or psychiatric problems, the current study didn't find these side effects.
"Of the first-line treatments used for smoking cessation, which also include various forms of nicotine replacement therapy and the prescription medication bupropion, varenicline is the most effective," said Robert Reid of the University of Ottawa Heart Institute.
Reid, author of an accompanying editorial, has received fees from Pfizer, maker of varenicline, and Johnson and Johnson, maker of various nicotine replacement products. One advantage of the drug is that it dulls the effect of nicotine in the brain, making cigarettes less pleasurable.
Nicotine replacement therapies, or e-cigarettes containing nicotine, may help reduce withdrawal by delivering smaller amounts of nicotine than traditional cigarettes, Reid said by email.
"The vast majority of smokers have made multiple quit attempts, with and without assistance and generally have some idea about how they respond to the currently available treatments," Reid added. "There is strong evidence that using these treatments, combined with behavioural support, makes it significantly more likely that smokers will be able to achieve long-term abstinence from tobacco."