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Are electronic cigarettes effective for smoking cessation?

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Electronic cigarettes (e-cigarettes) have been promoted as both a safer alternative to tobacco and as an aid to quit smoking. A new study set out to determine whether e-cigarettes were an effective smoking cessation method as well as to evaluate how tightly they should be regulated. The findings were published online on March 24 in the journal JAMA Internal Medicine by researchers at the University of California, San Francisco.

The study authors note that e-cigarettes are aggressively promoted as aids to quit smoking; however, studies to date have been unconvincing. One clinical trial comparing e-cigarettes with and without nicotine to a nicotine patch reported no differences in six-month quit rates. Other studies have also reported no benefit of e-cigarette use and quitting. An international study found that 85% of smokers who used e-cigarettes to quit; however, e-cigarette users did not quit more frequently than nonusers.4 Another study reported that among US quitline callers, e-cigarette users were less likely to have quit at seven months than nonusers.

In view of the foregoing, the investigators conducted a longitudinal (over time) assessment of a national sample of current US smokers to determine whether e-cigarette use predicted either successful quitting or reduced cigarette smoking. They analyzed 2011 survey data collected from 949 smokers. Among them, 88 reported using e-cigarettes. When the investigators evaluated thee smokers' responses a year later, they found that the individuals who reported using e-cigarettes in the 2011 survey were no more likely to quit smoking than ones who did not use e-cigarettes. A limitation of the study was the small number of subjects.

Since their introduction in China in 2004, e-cigarettes have grown into a $2 billion industry. The battery-powered devices allow smokers to inhale nicotine-infused vapors, which do not contain the harmful tar and carbon monoxide in tobacco. Controversy currently exists as to how strictly US health regulators should control the products. Proponents note that e-cigarettes can help smokers quit; however, public health experts caution fear they can serve as a gateway to take up smoking, particularly among teenagers.