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Some e-cigarette users may have difficulty quitting smoking



(Reuters Health) – Smokers who say they want to give up the habit may find it easier to avoid using e-cigarettes, a US study suggests.

The researchers tested two smoking cessation approaches for 1,357 adult smokers who were hospitalized and who expressed a desire to quit. Patients were randomly assigned to receive a free smoking cessation assistance or to join a control group who could call a telephone hotline for smoking cessation counseling.

Overall, 28 percent of participants occasionally used e-cigarettes within three months of discharge.

Six months after leaving the hospital, about 10 percent of people who had used e-cigarettes in the first three months after discharge had successfully stopped smoking traditional cigarettes, compared to 27 percent of those who did not E-cigarettes used found.

Although this study is not intended to prove whether or how e-cigarettes could directly influence the likelihood of smoking cessation, this suggests that occasional e-cigarettes common to study participants do not support these efforts. said Nancy Rigotti, director of the study at Harvard Medical School and director of the Tobacco Research and Treatment Center at the Massachusetts General Hospital in Boston.

"The study is in line with the hypothesis that smokers must use e-cigarettes on a regular and daily basis and change completely from cigarettes to e-cigarettes in order to have the greatest chance of getting help," said Rigotti, who receives research funding has Pfizer, manufacturer of the smoking cessation drug Chantix, via email.

Large American tobacco companies are developing all e-cigarettes. The battery-powered gadgets feature a glowing tip and a heating element that turns liquid nicotine and flavors into a vapor cloud inhaled by users.

If e-cigarettes contain nicotine, they can be addictive like traditional cigarettes. Even without nicotine, previous research suggests that flavors and other ingredients in e-liquids used for vaporizing can be associated with serious respiratory problems.

A big question about e-cigarettes, whether they are safe or at least safer than traditional cigarettes, is not answered by the current study.

Many smokers who try to quit fail, no matter what weaning aid they're trying, and a separate study provides new evidence that even drugs are not a foolproof tool.

For this study, researchers randomly assigned 302 smokers with heart problems to either additional varenicline (Chantix) or placebo pill for 1

2 weeks.

One year later, lab tests showed that about 40 percent of varenicline participants quit smoking compared to 29 percent with placebo, researchers report in the Canadian Medical Association Journal.

"These patients are at high risk for recurrent cardiovascular events (eg, heart attacks, unstable angina, and mortality) if they continue to smoke," said lead author Sarah Windle of the General Hospital in Montreal.

While some previous studies have linked varenicline to an increased risk of heart or psychiatric problems, the current study did not find these side effects.

"Our results suggest that varenicline is effective and safe for smoking cessation in this important patient population," Windle said via email.

"From the first-line smoking cessation treatments, which include various forms of nicotine replacement therapy and the prescription drug bupropion, varenicline is most effective," said Robert Reid of the University of Ottawa Heart Institute. Reid, author of an accompanying editorial, has received royalties from Pfizer, manufacturer of varenicline, and Johnson and Johnson, makers of various nicotine replacement products.

One benefit of the drug is that it dulls the effects of nicotine in the brain, making cigarettes less enjoyable. Nicotine replacement therapies or e-cigarettes containing nicotine may help reduce withdrawal by delivering smaller amounts of nicotine than traditional cigarettes, Reid said via email.

"The vast majority of smokers have made several attempts to quit with and without support and generally have an idea of ​​how they are responding to currently available treatments," Reid added. "There is strong evidence that using these treatments in combination with behavioral support makes it much more likely that smokers will be able to achieve long-term tobacco abstinence."

SOURCES: bit.ly/2pH27f9 Annals of Internal Medicine, online March 26, 2018 and bit.ly/2pJ2xSh Canadian Medical Association Journal, online March 26, 2018.


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