Counseling, E-Cigarettes Improve Smoking Cessation

According to late-breaking clinical trial science presented digitally at ACC.20/WCC, patients who received smoking cessation counseling and also used electronic cigarettes with nicotine were more likely to be successful at quitting smoking, than patients who received counseling alone.

In a randomized, parallel trial, sponsored by the Canadian Institutes of Health Research, Mark J Eisenberg, MD, MPH, FACC, and colleagues grouped patients by nicotine e-cigarettes plus counseling (n=128), nonnicotine e-cigarettes plus counseling (n=127), and only counselling (n=121). 

Patients were an average of 52 years, all active smokers willing to quit, with a mean of 35 years smoking, averaging 21 cigarettes a day at the beginning of the trial. 

According to the results of the study, the primary outcome, point prevalence abstinence at 12 weeks, was 22% in the nicotine e-cigarette group vs 17% in the non-nicotine e-cigarette group vs 9% in the counseling alone group (nicotine e-cigarette vs. counseling; relative risk [RR] 2.4, 95% confidence interval [CI] 1.3-4.6, non-nicotine e-cigarette vs. counseling; RR 1.9, 95% CI 1.0-3.8).

“These findings show that nicotine e-cigarettes are effective for smoking cessation in the short term,” said Dr Eisenberg. “Vaping is much more effective than counseling, though it’s not a magic bullet for smoking cessation.”

Secondary outcomes included reducing number of cigarettes a day to 8 in the nicotine e-cigarette group, 10 in the nonnicotine, and 14 in the counseling group. Continuous abstinence was 5%, 3%, and 1%, respectively.

“It is important to note that in this study the participants were chronic smokers, who were highly motivated to discontinue cigarettes in favor of a non-smoking form of nicotine,” said Kim A Eagle, MD, MACC, editor-in-chief of ACC.org. “The dose chosen was determined by the number of cigarettes used. This design acknowledges that nicotine is a drug that is highly addictive and supports the concept that substituting a less harmful type of nicotine such as gum, patch or e-cigarette, offers one mechanism by which to help smokers quit.” —Edan Stanley