Dr Hayden McRobbie Reader in Public Health Interventions, Wolfson Institute of Preventive Medicine, Queen Mary University of London
Abstract
The smoking cessation landscape has changed markedly in recent years with the availability of electronic cigarettes (EC). EC have become highly popular and are being used by smokers wanting to quit, but also among those who want to reduce the health risks of smoking tobacco.
The early EC were of variable quality, but this is improving. With experience users can achieve overall blood nicotine levels similar to those achieved with smoking conventional cigarettes, although EC are still someway from delivering nicotine as efficiently as tobacco smoke. Several studies have now demonstrated that EC reduce urges to smoke.
A major advantage of EC over smoking cessation medicines is that they provide a closer replacement for smoking, in that they deliver smoke-like mist with some of the sensations of smoking, which some smokers find important. EC also have high user rating of helpfulness compared to other smoking cessation medicines.
There are limited data regarding their use in smoking cessation treatment, but results from one trial show that EC were as effective as patches in helping people stop smoking for six months, when used in combination with minimal support.
Overall EC have a good short-term safety profile. No tobacco, smoke or combustion is involved in its operation and no clinically significant levels of any harmful chemicals have been detected in EC vapour. Although some health risks from EC use may yet emerge, these are likely to be at worst only a small fraction of the risks of smoking.
The tobacco control and public health sectors are divided in their views on EC, with some advocating for product bans whilst others believe that their full potential, in terms of reducing smoking related harm, will only be realised if they are left as a consumer product. Regardless of such differences most smokers want to stop smoking tobacco and many are looking to use EC to help them do so. Smoking cessation services should be open to EC use in people keen to try them; especially in those that have tried, but not succeeded, in stopping smoking with the use of licensed stop smoking medicines.
Source of funding: Hayden McRobbie is employed by Queen Mary University of London.
Declaration of interest: Hayden McRobbie was an investigator in a public-good funded ASCEND e-cigarette trial for which PGM International provided products at no cost, and has undertaken research on Ruyan e-cigarettes, for which the University of Auckland was funded by Health New Zealand, independently of Ruyan.
