Doubt cast over the effectiveness of e-cigarettes for stopping smoking
A group of 16 American experts claims that there is no evidence that electronic cigarettes can be recommended as a way to quit smoking.
Tobacco kills half of those who smoke it, and accounts for almost 6 million deaths per year worldwide. Anything goes when it comes to quitting: nicotine substitutes (patches, gum, tablets, inhalers), drugs, behavioral and cognitive thearapy, or even alternative medicine. ”But what about e-cigarettes?” you might ask. The 16 experts on the US Preventive Service Task Force, an American group working on prevention in public health, will tell you that there isn’t enough evidence to show that these devices are effective for stopping smoking.
The experts came to this conclusion after analysing the results of over fifty studies about the effectiveness of the various methods for smoking cessation. They published their synthesis a few days ago as a set of recommendations for health professionals. In it the scientists stress the lack of proof concerning the effects of e-cigarettes and do not recommend their use.
“There are hundreds of studies on the subject, but only 3 are randomized, and therefore the most reliable.” explained Jean-François Etter, a professor of Public Health at the University of Geneva. ”In a randomized study patients are randomly assigned to one of two identical groups, and in just one of them electronic cigarettes are used. This allows us to prove causality between e-cigarette smoking and cessation.”
In their view, only two methods are effective for curing addiction to smoking. The first is medication, using varenicline (commercially sold as Chantix or Champix), buproprion (an antidepressant called Zyban) or nicotine substitutes. The second is cognitive and behavioral therapy, whch is recommended in particular for pregnant women as a way to avoid the possible side effects of medication on foetal development.
The French tobacco addiction prevention service (Office français de prévention du tabagisme, or OFT) has noted that the commercial success of e-cigarettes coincides with a fall in cigarette sales (-7.6% at the end of 2013) and a reduction in the use of traditional methods of giving up. In a statement published last year the OFT states that “e-cigarettes are a lot less harmful than traditional cigarettes” and that “replacing tobacco smoking with e-cigarettes can reduce health risks”. Since 2014 the national health authority has also been recommending to doctors not to discourage the use of e-cigarettes for people who wish to give up smoking.
Despite the prudence of the authorities, the e-cigarette is viewed by many smokers as an alternative to tobacco. A study of 15000 people carried out in 2014 by the national institute for health prevention and education showed that more than 80% of vapers said that e-cigarettes had enabled them to reduce their tobacco consumption, on average by 9 cigarettes each day.