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E-cigarettes No Guarantee Against Relapse for Smokers

October 22, 2021 – Former smokers who use e-cigarettes are just as likely to re-ignite as those who use other nicotine alternatives, new evidence reveals.

A recent study has shown that people who stop smoking and start using e-cigarettes are just as likely to switch back to traditional tobacco cigarettes as people who have switched to nicotine gum and other products.

Quitting smoking altogether was the most effective strategy. Overall, the use of e-cigarettes or another tobacco product was associated with an 8.5% higher chance that a recent smoker would smoke again, compared to people who became “cold turkeys” .

The study was published on October 19 in JAMA network open.

Interestingly, the results come the week after the FDA announced its first e-cigarette clearance for three Vuse tobacco flavored vaping products. Data from manufacturer RJ Reynolds showed that the products “could benefit addicted adult smokers who switch to these products – either completely or with a significant reduction in cigarette consumption – by reducing their exposure to harmful chemicals,” said the FDA in a press release.

Electronic shutdown?

“We were very surprised at the FDA clearance to allow the marketing of certain electronic cigarettes to help smokers quit,” said John P. Pierce, PhD, lead author of the relapse study. smoking.

The current article asks a different question about electronic cigarettes, compared to two previous studies by Pierce and colleagues. A December 2020 study evaluated e-cigarettes as a long-term aid in quitting smoking. Another study, in September 2020, compared the use of e-cigarettes, other aids, and stopping cold smoking.

But “none of our work has found a benefit in using e-cigarettes to quit smoking,” said Pierce, professor emeritus in the Department of Family Medicine and Public Health at the University of California, San Diego.

So the researchers decided to test whether people who had already quit smoking were more likely to resume smoking within a year – to relapse – if they switched to e-cigarettes, to a product like nicotine patches. , or just stop completely.

Almost one in four dropouts have switched to electronic cigarettes

Pierce and his colleagues studied 13,604 cigarette smokers as part of the US Population Assessment of Tobacco and Health study. At the first annual follow-up, 9.4% had recently quit smoking.

Of this group of 1,228 recent ex-smokers, 37% have switched to a tobacco product other than cigarettes, including 23% who have switched to electronic cigarettes. The remaining 63% have remained tobacco-free. Non-Hispanic whites, those most addicted to tobacco, and those with annual incomes over $ 35,000 were more likely to switch to e-cigarettes.

To complicate matters, some people smoke cigarettes and use e-cigarettes where smoking is prohibited. But it doesn’t count as a “harm reduction” goal to switch to a supposedly safer product, Pierce and colleagues say.

“The harm reduction potential of electronic cigarettes requires that those who attempt to quit successfully move away from cigarettes altogether and not become users of two products.”

A hotly debated subject

Meanwhile, the controversy over electronic cigarettes as a way to quit smoking continues.

The issue “continues to be hotly debated,” writes Terry F. Pechacek, PhD, in a commentary published with the study.

“These new findings add to the growing body of evidence from randomized trials and observational studies examining the effect of switching to e-cigarettes on smoking cessation,” said Pechacek, professor of health policy and management at Georgia State University in Atlanta.

The study, he said, “provides further evidence suggesting that switching to electronic cigarettes in a real environment could lead to higher rates of relapse into smoking.”

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