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Umesh Modi is a chartered accountant, and Pamini Jatheeskumar is a chartered certified accountant at Silver Levene...
  Don Lavoie is alcohol programme manager at Public Health England and Gul Root is lead...
Don Lavoie is alcohol programme manager at Public Health England and Gul Root is lead pharmacist, Health and Wellbeing Directorate, Public Health England
More inWhite Papers  

ecigMarch 16 2016

People trying to give up smoking are more likely to use e-cigarettes than licensed nicotine replacement therapy, new data suggests. By the end of 2015, 20% (1.6million) of smokers were using an e-cigarette, the British Heart Foundation has said.

Announcing the figure on No Smoking Day, BHF pointed out that previous studies have found that using e-cigarettes when attempting to quit smoking improves the chances of success by around 50%, compared with using no aid or a licensed nicotine product bought from a shop with no professional support.

Professor Robert West, who led the study at University College London, said: “E-cigarettes have overtaken more traditional methods as the most widely used support for smokers wanting to quit. We can do much better in encouraging more smokers to try to stop and ensure that they are well informed about the best ways of succeeding.

“The strongest evidence is for use of a prescription medicine plus specialist behavioural support but e-cigarettes can be helpful for smokers who do not want to use professional support.”

BHF Associate Medical Director Dr Mike Knapton added: “We already know that nearly one in five adults in the UK smokes, and it is essential that they are supported and informed on their journey to quitting for good.”

Further research has been published this week suggesting smokers stand a slightly better chance of quitting if they do not wean themselves off cigarettes but just stop tobacco abruptly and use NRT and/or healthcare professional support if necessary.

The BHF-funded study was carried out by researchers from the Universities of Oxford, Birmingham and London, with 697 adult smokers participating. Study groups were split into those who quit smoking abruptly and those who reduced smoking gradually by 75% in the two weeks before quitting. Both groups received behavioral support from nurses and used nicotine replacement before and after quit day.

The primary outcome measure was prolonged validated abstinence from smoking four weeks after quit day, and the secondary outcome was prolonged, validated, six-month abstinence. At four weeks, 39.2% of the participants in the gradual cessation group were abstinent compared to 40.9% of those who had stopped abruptly. At six months, the corresponding figures were 15.5% compared to 22.0%.

The researchers concluded: “Quitting smoking abruptly is more likely to lead to lasting abstinence than cutting down first, even for smokers who initially prefer to quit by gradual reduction.”

Among the reasons postulated for the difference was that gradual reduction will require advance planning which many smokers may have difficulty organising. In addition, people opting for a gradual reduction may also be less motivated. An editorial commenting on this study points out that gradual reduction may still have a place as it can encourage smokers who have tried on a number of occasions to abruptly quit.

Links:

BHF statement on e-cigarettes

N Lindson-Hawley et al. Gradual Versus Abrupt Smoking Cessation: A Randomized, Controlled Non-inferiority Trial. Ann Intern Med. Published online March 15 2016

GS Ferreira and MB Steinberg. ‘Going Slow May Not Be Best When Quitting Smoking’. Ann Intern Med. Published online March 15 2016

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