Blog | Wednesday, March 26, 2014

QD: News Every Day--E-cigarettes may not help with smoking


Use of e-cigarettes isn’t associated with smoking cessation 1 year later, a small study found.

The authors analyzed self-reported data from 949 smokers (88 of the smokers used e-cigarettes at baseline) to determine if e-cigarettes were associated with more successful quitting or reduced cigarette consumption.

Results appeared online March 24 in a Research Letter at JAMA Internal Medicine.

E-cigarette use at baseline did not significantly predict quitting 1 year later (OR, 0.71; 95% CI, 0.35 to 1.46; P=0.35), the authors found. A second model based on intent, consumption and dependence found that intention to quit (OR, 5.59; 95% CI, 2.41 to 12.98; P<0.001) and cigarettes smoked per day (OR, 0.97; 95% CI, 0.94 to 0.99]; P=0.02) significantly predicted quit status. But, past 30-day e-cigarette use did not (OR, 0.76; 95% CI, 0.36 to 1.60]; P=0.46). E-cigarette use at baseline was not associated with a change in cigarette consumption among 821 people who smoked at baseline and follow-up (P=0.25), after controlling for baseline cigarette consumption.

The authors acknowledge the low numbers of e-cigarette users in the study may have limited their ability to detect an association between e-cigarettes use and quitting.

“Nonetheless, our data add to the current evidence that e-cigarettes may not increase rates of smoking cessation,” they wrote. “Regulations should prohibit advertising claiming or suggesting that e-cigarettes are effective smoking cessation devices until claims are supported by scientific evidence.”

In a related editor’s note, Mitchell H. Katz, MD, FACP, a deputy editor of JAMA Internal Medicine, writes: “Unfortunately, the evidence on whether e-cigarettes help smokers to quit is contradictory and inconclusive. Grana and colleagues increase the weight of evidence indicating that e-cigarettes are not associated with higher rates of smoking cessation.”

Still, he supported regulation and advertising restrictions on e-cigarette advertising, adding “[W]e simply do not know what potential harm e-cigarettes may cause to their users.”

Learn more about e-cigarettes and counseling patients who use them in ACP Internist’s March 2014 story, and in a blog post by John H. Schumann, MD, FACP, that appeared at his site, GlassHospital.