March 31, 2014

Stanton A. Glantz, PhD

More evidence that ecigarettes are not reducing smoking

On March 24, 2014, Rachel Grana, Lucy Popova, and Pam Ling published "A Longitudinal Analysis of Electronic Cigarette Use and Smoking Cessation" in JAMA Internal Medicine.  Their bottom line:

Consistent with the only other longitudinal population-level study with 1-year follow-up that we are aware of, we found that e-cigarette use by smokers was not followed by greater rates of quitting or by reduction in cigarette consumption 1 year later. ... [O]ur data add to the current evidence that e-cigarettes may not increase rates of smoking cessation. Regulations should prohibit advertising claiming or suggesting that e-cigarettes are effective smoking cessation devices until claims are supported by scientific evidence.

The paper was accompanied by an editoral note from Mich Katz, "If Only Electronic Cigarettes Were Effective Smoking Cessation Devices," which said in part:

Harm reduction is one of the pillars of modern public health. For example, when people criticized methadone treatment as only substituting one drug for another (heroin), public health advocates pointed to research showing that methadone use led to users decreasing or ceasing their heroin use and living more functional lives. Thus, as a harm reduction proponent, I would be willing to put aside the fact that any product with the name “cigarette” (e- or otherwise) causes me reflex tachycardia and support electronic cigarettes (e-cigarettes or electronic nicotine delivery systems) if there were good data indicating that they helped smokers to stop.

Unfortunately, the evidence on whether e-cigarettes help smokers to quit is contradictory and inconclusive. Grana and colleagues increase the weight of evidence indicating that e-cigarettes are not associated with higher rates of smoking cessation. Using longitudinal data from a web-enabled panel, they found that among smokers use of e-cigarettes was not associated with quitting 1 year later or smoking fewer cigarettes.

This is a longitudinal study, which supports "causal" conclusions.  It is also important to not that the authors controlled for level of addiction among the subjects.

Add new comment

Plain text

  • No HTML tags allowed.
  • Web page addresses and e-mail addresses turn into links automatically.
  • Lines and paragraphs break automatically.