Thursday September 19, 2019

E-Cigarettes Twice As Effective In Helping Smokers Quit: Study

Ian Armitage was skeptical about e-cigarettes as a way to stop smoking, saying he tried vaping several years ago but gave it up.

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E-cigarettes, Smokers
A woman smokes an electronic cigarette in London, Aug. 19, 2015. VOA

A major new study provides the strongest evidence yet that vaping can help smokers quit cigarettes, with e-cigarettes proving nearly twice as effective as nicotine gums and patches.

The British research, published Wednesday in the New England Journal of Medicine, could influence what doctors tell their patients and shape the debate in the U.S., where the Food and Drug Administration has come under pressure to more tightly regulate the burgeoning industry amid a surge in teenage vaping.

“We know that patients are asking about e-cigarettes and many doctors haven’t been sure what to say,” said Dr. Nancy Rigotti, a tobacco treatment specialist at Harvard Medical School who was not involved in the study. “I think they now have more evidence to endorse e-cigarettes.”

At the same time, Rigotti and other experts cautioned that no vaping products have been approved in the U.S. to help smokers quit.

e-cigarette, smokers
Packages of flavored liquids for e-cigarettes are seen displayed at a smoke shop in New York City. VOA

 

Top cause of preventable death

Smoking is the No. 1 cause of preventable death worldwide, blamed for nearly 6 million deaths a year. Quitting is notoriously difficult, even with decades-old nicotine aids and newer prescription drugs. More than 55 percent of U.S. smokers try to quit each year, and only about 7 percent succeed, according to government figures.

Electronic cigarettes, which have been available in the U.S. since about 2007 and have grown into a $6.6 billion-a-year industry, are battery-powered devices that typically heat a flavored nicotine solution into an inhalable vapor.

Most experts agree the vapor is less harmful than cigarette smoke since it doesn’t contain most of the cancer-causing byproducts of burning tobacco. But there is virtually no research on the long-term effects of the chemicals in the vapor, some of which are toxic.

At the same time, there have been conflicting studies on whether e-cigarettes actually help smokers kick the habit. Last year, an influential panel of U.S. experts concluded there was only “limited evidence” of their effectiveness.

In the new study, researchers tracked nearly 900 middle-age smokers who were randomly assigned to receive either e-cigarettes or nicotine replacement products, including patches, gums and lozenges. After one year, 18 percent of e-cigarette users were smoke-free, versus 9.9 percent of those using the other products.

“Anything which helps smokers to avoid heart disease and cancer and lung disease is a good thing, and e-cigarettes can do that,” said Peter Hajek, study co-author and an addiction specialist at Queen Mary University of London.

e-cigarette, cigarettes
Customers puff on e-cigarettes at the Henley Vaporium in New York City. VOA

More rigorous

The study was more rigorous than previous ones, which largely surveyed smokers about e-cigarette use. Participants in this experiment underwent chemical breath testing.

Smokers in the e-cigarette group received a $26 starter kit, while those in the nicotine-replacement group received a three-month supply of the product of their choice, costing about $159. Participants were responsible for buying follow-up supplies.

“If you have a method of helping people with smoking cessation that is both more effective and less costly, that should be of great interest to anyone providing health services,” said Kenneth Warner, a retired University of Michigan public health professor who was not involved in the study.

Several factors may have boosted the results: All the participants were recruited from a government smoking-cessation program and were presumably motivated to quit. They also received four weeks of anti-smoking counseling.

The researchers didn’t test e-cigarettes against new drugs such as Pfizer’s Chantix, which has shown higher rates of success than older nicotine-based treatments.

Funding for the study came from the British government, which has embraced e-cigarettes as a potential tool to combat smoking through state-run health services. Some of the authors have been paid consultants to makers of anti-smoking products.

e-cigarette, vaping
In this April 11, 2018, photo, an unidentified 15-year-old high school student uses a vaping device near the school’s campus in Cambridge, Mass. Health and education officials across the country are raising alarms over wide underage use of e-cigarettes and other vaping products. The devices heat liquid into an inhalable vapor that’s sold in sugary flavors like mango and mint — and often with the addictive drug nicotine. VOA

Long-term questions

U.S. health authorities have been more reluctant about backing the products, in part because of the long-term effects are unknown.

“We need more studies about their safety profile, and I don’t think anyone should be changing practice based on one study,” said Belinda Borrelli, a psychologist specializing in smoking cessation at Boston University.

The American Heart Association backed e-cigarettes in 2014 as a last resort to help smokers quit after trying counseling and approved products. The American Cancer Society took a similar position last year.

An editorial accompanying the study and co-written by Borrelli recommended e-cigarettes only after smokers have tried and failed to quit with FDA-approved products. Also, doctors should have a clear timeline for stopping e-cigarette use.

Borrelli noted that after one year, 80 percent of the e-cigarette users in the study were still using the devices. Nine percent of the participants in the other group were still using gums and other nicotine-replacement products.

E-cigarettes, Smokers
Talia Eisenberg, co-founder of the Henley Vaporium, uses her vaping device in New York, Feb. 20, 2014. VOA

No vaping company has announced plans to seek FDA approval of its products as a quit-smoking aid. Winning such an endorsement would require large studies that can take years and cost millions of dollars.

The FDA has largely taken a hands-off approach toward vaping. It has not scientifically reviewed any of the e-cigarettes on the market and has put off some key regulations until 2022. FDA Commissioner Scott Gottlieb has said he doesn’t want to over-regulate an emerging industry that could provide a safer option for adult smokers.

The delay has come under intense criticism amid an explosion in teenage vaping, driven chiefly by devices like Juul, which resembles a flash drive. Federal law prohibits sales to those under 18, but 1 in 5 high school students reported vaping last year, according to a government survey. It showed teenage use surged 78 percent from 2017 to 2018.

Tank vs. cartridge

Matthew Myers of the Campaign for Tobacco-Free Kids noted that the British study used so-called tank-based e-cigarettes, which allow users to customize their flavors and nicotine levels. Those devices have largely been overtaken in the U.S. by Juul and similar devices that have prefilled nicotine cartridges, or pods. Any benefit of e-cigarettes depends on the individual product and how it is used, he said.

“It is a fundamental mistake to think that all e-cigarettes are alike,” Myers said. “And in the absence of FDA regulation, a consumer has no way of knowing if the product they are using has the potential to help them or not.”

e-cigarette
E-cigarette additives impair lung function: Study.

Myers’ group is one of several anti-smoking organizations suing the FDA to immediately begin reviewing e-cigarettes.

Ian Armitage was skeptical about e-cigarettes as a way to stop smoking, saying he tried vaping several years ago but gave it up after experiencing twitching and shakes from nicotine withdrawal.

Also Read: Daily Cigarette Smoker Develop Greater Risks of Heart Attack, Says Study

`I tried it for a whole month, but it just wasn’t doing it for me,” said Armitage, an audio-visual technician in Washington. “I still wanted a cigarette afterward.”

Armitage, who has smoked for 15 years, said he also tried nicotine patches but found they irritated his skin. (VOA)

Next Story

U.S. Health Officials Urges People to Stop Vaping

Officials have identified about 450 possible cases, including as many as five deaths, in 33 states

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US, Health, Vaping
FILE - A man exhales while smoking an e-cigarette in Portland, Maine, Aug. 28, 2019. VOA

U.S. health officials on Friday again urged people to stop vaping until they figure out why some are coming down with serious breathing illnesses.

Officials have identified about 450 possible cases, including as many as five deaths, in 33 states. The count includes newly reported deaths in California, Indiana and Minnesota.

No single vaping device, liquid or ingredient has been tied to all the illnesses, officials said. Many of the sickened — but not all — were people who said they had been vaping THC, the chemical that gives marijuana its high. Many are teens.

Health officials have only been counting certain lung illnesses in which the person had vaped within three months. Doctors say the illnesses resemble an inhalation injury, with the body apparently reacting to a caustic substance that someone breathed in. Symptoms have included shortness of breath, fatigue, chest pain and vomiting.

US, Health, Vaping
FILE – A woman takes a puff from a cannabis vape pen in Los Angeles, Dec. 22, 2018. VOA

The illnesses have all surfaced this year, and the number has been growing quickly in the last month as more states have begun investigations. A week ago, U.S. officials pegged the number at 215 possible cases in 25 states.

It’s unclear whether such illnesses were happening before this year.

“We’re all wondering if this is new or just newly recognized,” Dr. Dana Meaney-Delman of the Centers for Disease Control and Prevention told reporters Friday.

An Illinois health official, Dr. Jennifer Layden, said officials there don’t know when such illnesses first began, but she said there has been a marked increase since spring.

Also Read- India’s Ambitious Mission to Land Unmanned Probe on Moon Suffers Setback

Deaths

Deaths previously were reported in Illinois and Oregon.

Indiana officials said the person who died there was an adult, but they didn’t say when it happened or release other details. Health officials in Los Angeles said they were investigating a vaping death as well. And Minnesota health officials said that state’s first known vaping-related death was a person over 65 years with a history of lung problems who had vaped illicit THC products and died in August.

Recent attention has been focused on devices, liquids, refill pods and cartridges that are not sold in stores.

US, Health, Vaping
U.S. health officials on Friday again urged people to stop vaping until they figure out why some are coming down with serious breathing illnesses. Pixabay

New York state has focused its investigation on an ingredient called Vitamin E acetate, which has been used to thicken marijuana vape juice but is considered dangerous if heated and inhaled. State investigators have found the substance in 13 cartridges collected from eight patients. In several cases, the ingredient made up more than half of the liquid in the cartridge.

CDC officials said they are looking at several ingredients, including Vitamin E acetate. But Meaney-Delman added that no single factor has been seen in every case.

Vaping nicotine

Also Friday, the New England Journal of Medicine released a series of articles that give medical details about cases reported in Illinois, Wisconsin and Utah.

Also Read- Silicon Valley A Punching Bag For Presidential Hopefuls

An article on 53 illnesses in Illinois and Wisconsin noted that nearly one-fifth of the cases were people who said they vaped nicotine and not anything that contained THC or CBD oil.

For that reason, doctors and health officials are continuing to suggest people stay away from all vaping products until the investigation establishes exactly what’s at the root of the illnesses.

Meaney-Delman said avoiding vaping is “the primary means of preventing this severe lung disease.”

It’s not yet clear what impact the recent illnesses are having on vaping rates, but some health officials are hoping more Americans will become wary.

There’s been a split among public health experts about the value of vaping nicotine. Some argue e-cigarettes are not as lethal as conventional cigarettes and can be a valuable aide to smokers trying to kick the habit.

But others say studies have not established that adult smokers who try vaping end up quitting smoking long term. And they fear that kids who might never have picked up cigarettes are taking up vaping.

The National Association of County and City Health Officials “has long been cautious about endorsing e-cigarettes even before the recent spate of illnesses, because little scientific evidence exists to show that e-cigarettes and other nicotine delivery devices are effective cessation devices,” spokeswoman Adriane Casalotti said in a statement.

The states reporting vaping-related lung illnesses to the CDC are Arkansas, California, Colorado, Connecticut, Delaware, Florida, Georgia, Iowa, Illinois, Indiana, Kansas, Kentucky, Louisiana, Maryland, Michigan, Minnesota, Montana, North Carolina, Nebraska, New Jersey, New Mexico, New York, Ohio, Oregon, Pennsylvania, South Carolina, Tennessee, Texas, Utah, Virginia, Vermont, Wisconsin, and West Virginia. (VOA)