A new important study provides the most solid evidence that, however, vaping can help smokers stop cigarettes, and electronic cigarettes are practically twice as effective as nicotine gums and patches.
British research, published Wednesday in the New England Journal of Medicine, could influence what doctors explain to their patients and formulate the debate in the United States, where the Drug and Food Administration has been pressured to regulate more firmly the industry blooming in the midst of an increase in vaping teens.
"We know that patients ask about electronic cigarettes and many doctors do not know what to say," said Dr. Nancy Rigotti, specialist in tobacco treatment at the Harvard Medical School, who did not participate in the study. "I think they now have more evidence to support electronic cigarettes."
At the same time, Rigotti and other experts warned that they have not approved vaping products in the United States to help smokers quit smoking.
Smoking is the world's leading cause of death, the fault of almost 6 million deaths a year. Quitting smoking is notoriously difficult, even with the help of nicotine decades and more recent medications. More than 55 percent of US smokers try to quit smoking every year, and only 7 percent are successful, according to government data.
Electronic cigarettes, which have been available in the United States since 2007, and have become an industry of 6.6 billion dollars a year, are battery-operated devices that usually warm up a nicotine solution with an inhalable flavor.
Most experts agree that steam is less harmful than cigar smoke, as it does not contain the majority of the by-products that cause cancer of the tobacco cream. But there is virtually no research on the long-term effects of chemical products on steam, some of which are toxic.
At the same time, there have been contradictory studies on whether electronic cigarettes help smokers to do so. Last year, an influential group of US experts concluded that there was only "limited evidence" of its effectiveness.
In the new study, researchers tracked about 900 middle-aged smokers who were randomly assigned to receive electronic cigarettes or nicotine replacement products, including patches, gums and tablets. After a year, 18% of consumers of e-cigarettes had no smoke, and 9.9% of those who used the other products.
"Everything that helps smokers to prevent heart disease and cancer and lung diseases is a good thing, and electronic cigarettes can do it," said Peter Hajek, a co-author of studies and an addiction specialist to the Queen Mary University of London.
The study was more rigorous than the previous ones, which largely surveyed smokers on the use of electronic cigarettes. The participants in this test underwent chemical respiration tests.
The smokers of the e-cigarette group received a $ 26 startup kit, while the nicotine replacement group received a three-month supply of the product they chose, with an approximate cost of $ 159. The participants were responsible for purchasing tracking supplies.
"If you have a method to help people with a cessation of smoking that is more effective and less expensive, it must be of great interest to anyone who provides health services," said Kenneth Warner, a retired public health professor at the University of Michigan that was not involved in the study.
Several factors may have increased the results: all participants were recruited in a government tobacco-cessation program and, no doubt, motivated to quit smoking. They also received four weeks of smoking cigar advice.
The researchers did not test electronic cigarettes against new drugs such as Chantix de Pfizer, which showed higher rates of success than older nicotine-based treatments.
Funds for the study come from the British government, which has embraced e-cigarettes as a potential tool to combat smoking through state health services. Some authors have received queries from manufacturers of anti-smoking products.
US health authorities have been reluctant to support the products, partly because of long-term effects that are unknown.
"We need more studies on their security profile and I do not think that anyone changes their practice based on a study," said Belinda Borrelli, a psychologist specializing in quitting smoking at the University of Boston.
The American Heart Association supported electronic cigarettes in 2014 as a last resort to help smokers quit after having advised and approved the products. The American Cancer Society assumed a similar position last year.
An editorial that accompanied the study and wrote co-written Borrelli recommended electronic cigarettes only after smokers had tried not to quit using FDA-approved products. In addition, doctors should have a clear calendar to stop smoking cigarettes.
Borrelli noted that, after a year, 80% of e-cigar consumers in the study continued to use the devices. The new percentage of the participants in the other group continued to use rubbers and other nicotine replacement products.
No vaping company has announced plans to seek the approval of the FDA of its products as a cessation aid. Winning this endorsement requires large studies that can take years and cost millions of dollars.
The FDA has largely taken a hands-on approach to the will. It has not scientifically reviewed any of the e-cigarettes on the market and has put some key regulations until 2022. FDA commissioner Scott Gottlieb has said he does not want to super-marshal an emerging industry that could provide a safer option for adult smokers
The delay has been subjected to intense criticisms in the midst of an adolescent age explosion, driven mainly by devices like Juul, which is similar to a flash drive. Federal law prohibits sales to under-18s, but 1 in 5 high school students reported that last year, according to a government poll, showed that the use of adolescence goes It increased 78% between 2017 and 2018.
Matthew Myers of the Non-Smoking Children's Campaign noted that the British study used the so-called electronic cigarettes based on baskets, which allow users to customize their flavors and nicotine levels. These devices have been widely exceeded in the United States by Juul and similar devices that have nicotine cartridges or prefabricated pods. Any advantage of electronic cigarettes depends on the individual product and how it is used, he said.
"It's a fundamental mistake to think that all e-cigarettes are the same," Myers said. "And in the absence of regulation of the FDA, a consumer has no way of knowing if the product that he is using has the potential to help them or not."
The Myers group is one of the various anti-smoking organizations that demand that the FDA immediately begin to review electronic cigarettes.
Ian Armitage was skeptical about electronic cigarettes as a way to quit smoking, saying he tried to get dirty several years ago, but abandoned it after experiencing bruises and bruises from nicotine withdrawal.
"I tried it for a whole month, but I did not do it for myself," said Armitage, an audio-visual technician in Washington. "I still want a cigarette after".
Armitage, who smoked for 15 years, said that she also tried nicotine patches but found that they irritated her skin.