E-cigarette users may struggle to quit smoking

Researchers tested two smoking cessation approaches for1,357 adult smokers who were hospitalized and expressed a desireto quit. Patients were randomly assigned to receive a freesupply of an approved smoking cessation aid or to join a controlgroup that could call a phone hotline for cessation advice.

Overall, 28 per cent of participants occasionally usede-cigarettes within three months after discharge.

Six months after they left the hospital, about 10 per cent ofpeople who reported using e-cigarettes over the first threemonths after discharge had successfully quit smoking traditionalcigarettes, compared with 27 per cent of those not usinge-cigarettes, lab tests found.

There is strong evidence that usingthese treatments, combined with behavioural support, makes itsignificantly more likely that smokers will be able to achievelong-term abstinence from tobacco.-Robert Reid

"The study is consistent with the hypothesis that smokersneed to use e-cigarettes regularly and daily and switchcompletely from cigarettes to e-cigarettes for them to have thegreatest chance of help," Rigotti, who has received researchfunding from Pfizer, maker of the smoking-cessation drugChantix, said by email.

The battery-powered gadgets feature a glowing tip and a heatingelement that turns liquid nicotine and flavourings into a cloudof vapour that users inhale.

• E-Cigarettes : Welcome Back, Big Tobacco

A big question about e-cigarettes, namely, whether they're safe or at least safer than traditional cigarettes, isn'tanswered by the current study.

Smoking in patients with heart problems

For this study, researchers randomly assigned 302 smokershospitalized with heart problems to receive either varenicline(Chantix) or a placebo pill for 12 weeks, in addition tocounselling.

One year later, lab tests showed that about 40 per cent ofthe participants quit smoking with varenicline, compared with 29per cent with placebo, researchers report in the Canadian MedicalAssociation Journal.

While some previous research has linked varenicline to anincreased risk of heart or psychiatric problems, the currentstudy didn't find these side effects.

"Of the first-line treatments used for smoking cessation,which also include various forms of nicotine replacement therapyand the prescription medication bupropion, varenicline is themost effective,"said Robert Reid of the University of OttawaHeart Institute.

Reid, author of an accompanying editorial, hasreceived fees from Pfizer, maker of varenicline, and Johnson andJohnson, maker of various nicotine replacement products. One advantage of the drug is that it dulls the effect ofnicotine in the brain, making cigarettes less pleasurable.

Nicotine replacement therapies, or e-cigarettes containingnicotine, may help reduce withdrawal by delivering smalleramounts of nicotine than traditional cigarettes, Reid said byemail.

"The vast majority of smokers have made multiple quitattempts, with and without assistance and generally have someidea about how they respond to the currently availabletreatments,"Reid added. "There is strong evidence that usingthese treatments, combined with behavioural support, makes itsignificantly more likely that smokers will be able to achievelong-term abstinence from tobacco."