Behavioural support is key when using e-cigarettes for smoking cessation - new research shows

Yesterday 31 January 2019, The NEW ENGLAND JOURNAL of MEDICINE (NEJM) published the following positive study ‘A Randomized Trial of E-Cigarettes versus Nicotine-Replacement Therapy’.

Letitia O’Dywer, Chief Executive Asthma and Respiratory Foundation NZ, reports: “It’s great to see a robust randomised controlled trial coming out in such a high impact journal on this subject.”

“As we know, smoking rates are higher for Māori and Pasifika peoples. This new study shows that e-cigarettes could be a useful tool in the battle against higher smoking rates, alongside wraparound smoking cessation services."

“We know that the place of e-cigarettes should be used in the context of current smokers quitting, and that evidence has been limited regarding their effectiveness compared with that of nicotine products which are FDA (Food and Drug Administration) approved as smoking-cessation treatments.”

“This randomised study just released yesterday, found that e-cigarettes were more effective for smoking cessation than nicotine-replacement therapy, when both products were accompanied by behavioural support,” says Letitia O'Dywer.

This paper supports the position of ARFNZ – that products should not be sold without behavioural support to quit smoking.

A total of 886 current smoking adults attending U.K. National Health Service stop-smoking services were randomly assigned to either nicotine-replacement products of their choice, including product combinations, provided for up to 3 months, or an e-cigarette starter pack. Results showed that at 1-year, abstinence rates for those in the e-cigarette group was 18% compared to 9.9% in the nicotine replacement therapy group. In this study e-cigarettes were more effective than nicotine-replacement therapy, when both products were accompanied by behavioural support.

Letitia O’Dywer continues: “If we are truly committed to Smokefree Aotearoa 2025, then e-cigarette and vaping products should be available only when accompanied by behavioural support and information around quitting smoking. They should not be sold as a stand-alone product if the argument for their introduction into New Zealand was to assist smokers to quit.”

In terms of access to these products, ARFNZ are very concerned around marketing to youth, and consequential uptake of never smokers, as well as setting standards around quality and safety of products with mandatory listing of ingredients. Additionally, the health effects of using e-cigarettes over the long-term are obviously still unknown.

ARFNZ strongly supports evidence-based medicine and looks forward to seeing future studies in robust journals such as the NEJM.