To Quit Smoking — Let’s All Vape

There is plenty of evidence to suggest that smoking e-cigarettes can be harmful — but now the Britain-based Royal College of Physicians thinks smokers should use them as a way to quit.

Their report says the devices are helping people more than harming them — at least so far.

“This is the first genuinely new way of helping people stop smoking that has come along in decades,” John Britton, director of the U.K. Center for Tobacco and Alcohol Studies at the University of Nottingham, said in a statement.

E-cigarettes deliver nicotine without the tar — and without some chemicals linked to cancer.

Dr. Michael Steinberg, who heads up the Tobacco Dependence Program at Rutgers University, told LifeZette that e-cigarette vapor is likely less harmful than tobacco smoke. “However, ‘less harmful’ is not safe,” he warned.

“E-cigarettes do contain harmful chemicals, just at much lower levels. We do not know the long-term health effects of e-cigarette use,” he said.

[lz_ndn video =30684197]

There are almost no randomized clinical trials looking at the effectiveness of e-cigarettes for tobacco dependence treatment, said Steinberg. The studies that have been published have “serious design flaws.”

“Much of the data that this report cites as demonstrating e-cigarettes [are] helping people quit smoking comes from population surveys and opinions of e-cigarette users,” Steinberg said. “It may be the case that e-cigarettes could help people quit — but to date, we really don’t have good scientific evidence of that claim.”

The RCP news comes just after the Centers for Disease Control and Prevention released a report saying that more kids are using e-cigarettes due to advertising. The CDC has been critical of the potential long-term effects of e-cigarette smoking, a practice also known as vaping.

[lz_related_box id=”109654″]

A study earlier this year in The Lancet Respiratory Medicine found that adult smokers who use e-cigarettes were 28 percent less likely to stop smoking cigarettes. It was a systematic review and meta-analysis of published data — the largest so far to determine if e-cigarettes help smokers stop puffing on traditional cigarettes.

In the study, Dr. Sara Kalkhoran, an instructor at Harvard Medical School, said e-cigarettes are linked to less quitting among smokers as they are currently being used.

“E-cigarettes should not be recommended as effective smoking cessation aids until there is evidence that, as promoted and used, they assist smoking cessation,” she said in a statement.

Dr. Brad Rodu, a professor and endowed chair of the Tobacco Harm Reduction Research program at the University of Louisville in Kentucky, said that the RCP’s statement means the “debate is over.”

He said Americans have ignored reports from the RCP on smoking before, but those reports wound up to be spot on. They’ve done the research and people need to trust it, Rodu said.

“Researchers and policy experts in the U.S. have been very resistant to any suggestion that tobacco harm reduction is a viable strategy,” Rodu told LifeZette.

He believes there’s “no doubt” that e-cigarettes can help people kick the habit of smoking tobacco cigarettes. “It’s become clear the RCP is making the right call,” Rodu said. “The research and policy conclusions are very solid.”

Steinberg said recommending e-cigarettes for smoking cessation shouldn’t be the case if the data is only based on observations.

[lz_related_box id=”89059″]

“Bottom line is that e-cigarettes alone are probably less harmful than tobacco alone, but e-cigarettes have not been proven to be safe nor have they been shown to significantly increase tobacco cessation,” he said.

He said public health concerns about using e-cigarettes with tobacco cigarettes (also known as “dual” usage) —especially its appeal to young people — should not be dismissed.

“These are serious potential problems for decades to come,” Steinberg added.

Ignoring the Evidence
Dr. Stanton Glantz, a professor at the University of California San Francisco Center for Tobacco Control Research and Education, said evidence “clearly” shows smokers who use e-cigarettes are less likely to kick the habit. While some people have used e-cigarettes to quit and the RCP researchers typically make sound recommendations, Glantz thinks they’ve made a big mistake in issuing the recommendation.

“They’re making policy by wishful thinking,” he told LifeZette. “They’re making policy based on what they hope will happen and ignoring what is actually happening.”

Glantz said more than 20 studies — including his own in The Lancet Respiratory Medicine, mentioned above — have shown e-cigarettes depress a person’s ability to quit. “They’re just ignoring the evidence,” Glantz said.

The fact that the Food and Drug Administration hasn’t stepped in as e-cigarettes continue to be marketed to young people isn’t helping matters much at all.

“Five years from now, these people are going to feel really bad,” Glantz added. “It’s a terrible precedent.”

“We are still very much in the ‘buyer beware’ stage with e-cigarettes,” Dr. Judith J. Prochaska, an associate professor at the Stanford Prevention Research Center, told LifeZette.  

“The claims far outweigh the evidence — the few randomized controlled trials conducted [a total of three] show nicotine e-cigarettes to be no different than placebo e-cigarettes,” she said, adding the data was largely observational with self-reported quit rates. Some data showed e-cigarettes increased quit attempts — but not abstinence. “A cessation medication would certainly not gain FDA approval with that type of evidence.”

“We know the studies that need to be conducted to yield conclusive evidence, and yet instead proclamations continue to be made without solid footing on an evidence base,” she added.