WASHINGTON (AP) – A major new study provides the strongest evidence yet that vaping can help smokers exit cigarettes, with e-cigarettes nearly twice as effective as nicotine gums and patches The New England Journal of Medicine Influencing what doctors tell their patients and shaping the debate in the US where the Food and Drug Administration has come under pressure to regulate the burgeoning industry as young people tap into vaping.
"We know that patients are asking for e-cigarettes, and many doctors were not sure what to say," Dr. Nancy Rigotti, specialist in tobacco treatment at Harvard Medical School, who was not involved in the study. "I think they now have more evidence to support e-cigarettes."
At the same time, Rigotti and other experts warned that no steam products were allowed in the US for smoking cessation.
Smoking is the # 1
Electronic cigarettes available in the US since about 2007 and growing to $ 6.6 billion a year The industry is a battery-powered device that typically warms a flavored nicotine solution into an inhalable vapor.
Most experts believe that steam is less harmful than cigarette smoke, as it does not contain most of the carcinogenic byproducts of burning tobacco. There is virtually no research on the long-term effects of the sometimes toxic chemicals in the vapor.
At the same time, there are conflicting studies on whether e-cigarettes actually help smokers get rid of the habit. An influential panel of US experts noted last year that there was "limited evidence" of their effectiveness.
In the new study, researchers tracked nearly 900 middle-aged smokers who accidentally received either e-cigarettes or nicotine replacement products, including plasters, gums, and lozenges. After one year, 18 percent of e-cigarette users were smoke-free, versus 9.9 percent of those who used the other products.
"Anything that helps smokers to avoid heart disease, cancer and lung disease is a good thing, and e-cigarettes can do that," said Peter Hajek, a co-author and addiction specialist at Queen Mary University in London.
The study was more rigorous than the previous ones, which largely questioned smokers about e-cigarette consumption. Participants in this experiment were subjected to chemical breath tests.
Smokers in the e-cigarette group received a $ 26 starter kit, while those in the nicotine replacement group received a three-month delivery of the product of their choice, which cost about $ 159. The participants were responsible for the purchase of follow-up material.
"If you help people with smoking cessation to be more effective and less costly, it should be of great interest to anyone who provides healthcare," said Kenneth Warner, a retired public health professor at the University of Michigan who did not was involved in the study.
Several factors may have increased the results: All participants were recruited from a state smoking cessation program and were probably motivated to drop out. They also received a four-week anti-smoking consultation.
The researchers did not test e-cigarettes for new drugs like Pfizer's Chantix, which had higher success rates than older nicotine-based treatments.
The study came from the UK government, which has adopted e-cigarettes as a potential anti-smoking tool by government health services. Some of the authors were paid consultants by manufacturers of anti-smoking products.
US. Health authorities were more reluctant to support the products, in part due to the long-term effects unknown.
"We need more studies on their safety profile, and I do not think anyone should change their practice," said Belinda Borrelli, a psychologist specializing in smoking cessation at Boston University.
The American Heart Association supported e-cigarettes in 2014 as a last resort to stop smokers from smoking after trying advice and approved products. The American Cancer Society had a similar position last year.
An editor-led article co-authored by Borrelli recommended e-cigarettes only after smokers tried to stop using FDA-approved products. In addition, doctors should have a clear timetable for stopping the use of e-cigarettes.
Borrelli found that 80 percent of the study's e-cigarette users were still using the devices after one year. Nine percent of participants in the other group still used gums and other nicotine replacement products.
No steam company has announced that it will apply for approval of its products by the FDA as a smoking cessation. To obtain such confirmation would require extensive studies that could take years and cost millions of dollars.
The FDA has largely committed to the vaping approach. It has not scientifically reviewed any of the e-cigarettes available on the market and has lifted some important regulations until 2022. FDA Commissioner Scott Gottlieb has said he does not want to over-regulate any emerging industry that could offer a safer adult option for smokers.
The delay was heavily criticized as teenage vaping spread mostly from devices like Juul, which resemble a flash drive. Federal law prohibits sale to persons under the age of 18, but one in five high school students reported fumes over the past year, according to a government poll. The use of adolescents increased by 78 percent between 2017 and 2018.
Matthew Myers of the Campaign for Tobacco-Free Children noted that the British study used so-called tank-based e-cigarettes, which allow users to customize their tastes and their nicotine levels. These devices have been largely overhauled in the US by Juul and similar devices that have preloaded nicotine cartridges or cups. Any benefit of e-cigarettes depends on the individual product and its use.
"It's a fundamental mistake to think that all e-cigarettes are the same," Myers said. "And without a FDA regulation, a consumer will have no way of knowing if the product he's using has the potential to help him or not."
The Myers Group is one of several anti-smoking organizations that begin to sue the FDA immediately with checking e-cigarettes.
Ian Armitage was skeptical of e-cigarettes to quit smoking. He said he tried to steam some years ago, but gave it up after experiencing twitching and shaking on nicotine withdrawal. I tried it for a month, but I just did not do it, "said Armitage. an audiovisual technician in Washington. "I wanted a cigarette later."
Armitage, who has been smoking for 15 years, said he had also tried nicotine patches, but found that they irritated his skin.