The use of electronic cigarettes not only does not help cigarette smokers who are not motivated to quit, but has the opposite effect, according to the results of a new study.
"In our study, people who smoked, in addition to smoking, actually started smoking more," said study lead researcher Nancy Anoruo, MD, of the University of Massachusetts School of Medicine at Worcester.
This is "completely inconsistent with what e-cigarette manufacturers tell us," he told Medscape Medical News.
In their study, Anoruo and colleagues looked at whether people were more likely to quit smoking if they smoked e-cigarettes in addition to conventional cigarettes. The research is a substudy of the ongoing Take a Break project, funded by the National Institutes of Health, which assesses whether a quit-motivational app helps smokers quit.
In a cohort of 405 smokers who were not motivated to quit, 248 were defined as double smokers after responding "yes" to "ever used" e-cigarettes, and 157 were defined as traditional smokers who only smoked fuel cigarettes. Most of the participants, 82%, were white, 8.8% were black, and 49% were women.
More dual smokers than traditional smokers were under the age of 40 (27% vs. 16%; (P = .02), Anoruo reported during his virtual presentation at the American Thoracic Society's 2020 International Conference.
Double smokers reported smoking an average of 16 cigarettes a day, compared to 14 a day for traditional smokers.
All smokers were encouraged to consider a 3-week period of withdrawal from combustible cigarettes. At the end of that period, the researchers compared the results reported by the participants.
Challenge of abstinence
Average withdrawal intervals were shorter for dual smokers than for traditional smokers (0.93 vs. 1.8 days; p = 0.01). And dual smokers reported that they had more difficulty quitting smoking completely (6.3% vs. 13.0%; P = .02).
At 6 months of follow-up, dual smokers smoked more cigarettes than traditional smokers (daily average, 12.0 vs. 9.4; P = .04). And the reduction in cigarette smoking from baseline was less for dual smokers than for traditional smokers (21% vs. 33%; p = 0.04).
"Electronic cigarettes are not a special magic bullet for people to stop smoking," said Anoruo.
In this study, quitting smoking was defined as withdrawal from combustible cigarettes, but that did not mean that participants abstained from nicotine.
"If, in the end, they quit smoking traditional cigarettes, we consider quitting smoking successful," Anoruo explained. This definition is in line with the school of thought that electronic cigarettes are a harm reduction tool.
"But now we know that electronic cigarettes are not necessarily safe," he added.
Still, it could be the lesser evil. "You end up ingesting less dangerous chemicals, so we consider quitting smoking if you stop smoking cigarettes," he said.
"We would like to study the psychology of cigarette smokers to find out if they see e-cigarettes as a smoking cessation aid," Anoruo said, and to see if "their belief is driven by the publicity they see about e-cigarette use." " "
A meager reduction
Similar results were shown last month in a study by Megan Piper, PhD, of UW – Madison in Wisconsin, and colleagues, who reported that dual use of e-cigarettes and fuel cigarettes "did not appear to be an effective way to stop consume fuels. cigarettes ".
After 1 year, double smokers smoked three fewer cigarettes each day than traditional smokers, which is "a meager reduction," Piper said in a news release.
"You generally can't have one foot in both camps. Most can't vape and smoke and expect to quit." "That sustained pattern will not help most people quit smoking."
International Conference of the American Thoracic Society (ATS) 2020: Poster 201. Presented online on May 17, 2020.
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