Family Encyclopedia >> Health

The electronic cigarette, an effective aid for smoking cessation


Vaping products are electronic devices designed to simulate the smoking of real cigarettes. The main difference being that these devices use a liquid, which when heated, produces vapor (and not carbon monoxide). These liquids can contain different levels of nicotine, or even zero. In this, electronic cigarettes could be an interesting aid to smoking cessation. A recent study conducted in the UK confirms this potential.

When it comes to e-cigarettes, or electronic cigarettes, opinions are often divided, including at the level of health authorities. Last November, the High Council for Public Health updated its opinion on the benefits and risks of this device:this report confirms that the electronic cigarette can be considered as an aid to stop or reduce the consumption of tobacco by smokers. , but at the same time, he points out that it can also be a gateway to smoking — especially among young consumers, seduced by the object and so many attractive aromas.

The same observation has been made by the World Health Organization, which is concerned that children who use these products are up to three times more likely to use tobacco products afterwards. The National Cancer Institute recalls, however, that the main carcinogenic substances or substances responsible for tobacco-related cardiovascular diseases "do not exist at significant rates in electronic systems". While there are still uncertainties about the long-term effects of e-cigarettes on health, their use as a weaning aid nevertheless seems to be bearing fruit, especially among pregnant women.

Twice as effective as nicotine patches for pregnant women

It is commonly offered to pregnant women who smoke nicotine patches to help them quit smoking - and thus preserve the health of the child they are carrying. Smoking during pregnancy increases the risk of miscarriage, premature birth and sudden infant death syndrome, among other serious consequences. However, these patches have limited effectiveness on this category of people.

Two drugs have also already been tested on pregnant women who smoke, in several placebo-controlled trials. One, known as nicotine replacement therapy (or NRT), has also shown limited effects (since nicotine is metabolized faster in pregnant women, the standard dose of NRT may have been too weak), while the other (bupropion) had no effect at all.

To identify a better approach to help these women, researchers from the Wolfson Institute of Population Health in London set out to assess the effectiveness of e-cigarettes as a withdrawal aid, compared to nicotine patches. According to the team, e-cigarettes have several advantages over traditional weaning aids:they make it possible to modulate the nicotine intake, to select a pleasant aroma and therefore to maintain a certain pleasure (provided both by the aroma chosen only by the gesture).

To carry out their study, the researchers recruited 1140 pregnant smokers from 24 English and Scottish hospital sites. The participants smoked 10 cigarettes a day and were pregnant for an average of 15.7 weeks. This cohort was divided into two groups:one received nicotine patches, the other used electronic cigarettes.

A recommended option in case of difficult weaning

First, the researchers found that the rates of prolonged abstinence (assessed through saliva tests performed at the end of pregnancy) were not significantly different between groups. But it turns out that some participants in the patch group had finally quit using an e-cigarette during the study! Finally, after correction, the withdrawal rates were 6.8% for the e-cigarettes group, and 3.6% for the “patches” group. As for self-reported smoking abstinence at the end of pregnancy, it was 19.8% in the e-cigarettes group compared to 9.7% in the patch group.

Furthermore, birth outcomes and adverse events were largely similar between the two groups, with the exception of low birth weight (<2.5 kg), which was less common in the affected group. electronic cigarettes (9.8%) than in the other group (14.8%). “Given the remaining questions about the risks of nicotine during pregnancy, it is better to quit smoking without using nicotine-containing products than to switch to such products “, underline the researchers. But when it comes to choosing between e-cigarettes or continued smoking, e-cigarettes are the recommended option, they add.

Note that a Cochrane review, which screened 61 studies on the effectiveness of electronic cigarettes as a cessation device, confirmed that they can help smokers quit smoking. “There was moderate-certainty evidence, limited by imprecision, that quit rates were higher among people who had used an e-cigarette “, write the authors. In addition, no serious side effects have been associated with their use (irritation of the throat and mouth were the most frequently reported side effects in the short and medium term).

As to whether these devices could serve as a "gateway" to smoking for non-smokers - particularly among children and adolescents - the first data from the Constances cohort on the subject are reassuring:they reveal that the use of electronic cigarette among non-smokers is "very rare" (11 subjects out of 8042). “The change over one year shows that no exclusive electronic cigarette user became a smoker one year later concludes the report, suggesting that e-cigarettes do not promote smoking, but are instead widely used to quit smoking.

Source:P. Hajek et al., Nature Medicine