E-cigarettes beat nicotine gum and patches to quit smoking

While e-cigarettes work slightly better than other nicotine replacement treatmentsto help people quit smoking, there are still manyunknown health effects of e-cigarettes, a new study suggests.

The study provides the strongest evidence yet that vaping can help smokers quit cigarettes, with e-cigarettes proving nearly twice as effective as nicotine gums and patches.

The British research, published Wednesday in the New England Journal of Medicine, could influence what doctors tell their patients and shape the debate in the U.S., where the Food and Drug Administration has come under pressure to more tightly regulate the burgeoning industry amid a surge in teenage vaping.

"We know that patients are asking about e-cigarettes and many doctors haven't been sure what to say," said Nancy Rigotti, a tobacco treatment specialist at Harvard Medical School who was not involved in the study. "I think they now have more evidence to endorse e-cigarettes."

At the same time, Rigotti and other experts cautioned that no vaping products have been approved in the U.S. to help smokers quit.

Safety profile unclear

Smokers in the e-cigarette group received a $26 starter kit, while those in the nicotine-replacement group received a three-month supply of the product of their choice, costing about $159. Participants were responsible for purchasing follow-up supplies.

I tried [vaping] for a whole month, but it just wasn't doing it for me.-IanArmitage

Funding for the study came from the British government, which has embraced e-cigarettes as a potential tool to combat smoking through state-run health services. Some of the authors have been paid consultants to makers of anti-smoking products.

U.S. health authorities have been more reluctant about backing the products, in part because there is virtually no research on the long-term effects of chemicals in e-cigarette vapor, some of which are toxic.

"We need more studies about their safety profile, and I don't think anyone should be changing practice based on one study," said Belinda Borrelli, a psychologist specializing in smoking cessation at Boston University.

The American Heart Association backed e-cigarettes in 2014 as a last resort to help smokers quit after trying counseling and approved products. The American Cancer Society took a similar position last year.

E-cigarettes not all alike

An editorial accompanying the study and co-written by Borrelli recommended e-cigarettes only after smokers have tried and failed to quit with FDA-approved products. Also, doctors should have a clear timeline for stopping e-cigarette use.

Borrelli noted that after one year, 80 percent of the e-cigarette users in the study were still using the devices. Nine percent of the participants in the other group were still using gums and other nicotine-replacement products.

No vaping company has announced plans to seek FDA approval of their products as a quit-smoking aid. Winning such an endorsement would require large studies that can take years and cost millions of dollars.

The FDA has largely taken a hands-off approach toward vaping. It has not scientifically reviewed any of the e-cigarettes on the market and has put off some key regulations until 2022. FDA Commissioner Scott Gottlieb has said he doesn't want to over-regulate an emerging industry that could provide a safer option for adult smokers.