CLINICAL QUESTION

Are e-cigarettes (vaping) effective for helping long-time smokers quit?

BOTTOM LINE

e-Cigarettes can help long-time smokers quit smoking for at least 6 months, although the effect may wane over time. In this study, the response to placebo was high (approximately 20%), which may indicate a motivated cohort or that the smoking cessation counseling received by the groups was effective. (Level of Evidence = 1b)

SYNOPSIS

The investigators recruited (via newspaper announcements) 458 people who smoked for at least 10 years and were interested in quitting. The participants were randomly assigned using concealed allocation to receive nicotine-containing e-cigarettes plus placebo tablets, varenicline (Chantix) plus nicotine-free e-cigarettes, or placebo e-cigarettes and placebo varenicline for 12 weeks. All participants received a total of eight sessions (30 minutes) of individualized smoking cessation counseling using motivational interviewing techniques. At 6 months (3 months after the end of the intervention), abstinence was confirmed in 40.4% of e-cigarette users, 43.8% of varenicline users, and 19.7% of placebo users. However, at 12 months, the rate of abstinence had worsened to 28.0% in the e-cigarette users and 37.9% in varenicline users. There was no difference in abstinence rates in the placebo group at 12 months (19.9%). The authors did not report on the likelihood of continuous e-cigarette use following the end of the intervention.