CDC report shows more smokers try to quit with e-cigs than nicotine replacement products

April 19 2017

Federal health regulators continue to de-emphasize electronic cigarettes and vaporizers as smoking-cessation options even as they acknowledge increased use of the products for that purpose.

The Centers for Disease Control and Prevention released Thursday a 26-month study of 15,943 adult cigarette smokers. It was published in the journal Preventing Chronic Disease.

The goal was determining what may be the most effective ways of quitting smoking among 10 common methods.

The study determined that 74.7 percent of survey participants used multiple methods during their most recent quit attempt.

“Giving up cigarettes all at once (65.3 percent) and reducing the number of cigarettes smoked (62 percent) were the most prevalent methods,” the CDC said.

When it came to a potential smoking-cessation device, substituting some cigarettes with e-cigs (35.3 percent) was used by a greater percentage of smokers than the nicotine patch or gum (25.4 percent) or other cessation aids approved by the Food and Drug Administration.

Switching completely from cigarettes to e-cigs was used by 24.7 percent. Other quit methods were: getting help from a doctor or health professional (15.2 percent), using smoking-cessation medications approved by the FDA (12.2 percent), help from a website (7.1 percent) or quitline (5.4 percent).

“Given that our data show that e-cigarettes are more commonly used for quit attempts than FDA-approved medications, further research is warranted on the safety and effectiveness of using e-cigarettes to quit smoking,” the CDC said.

“There is no conclusive scientific evidence that e-cigarettes are effective for long-term cessation of cigarette smoking. E-cigarettes are not approved by the FDA as a smoking cessation aid.”

The CDC said FDA-approved medications “have helped smokers to quit, in many instances doubling the likelihood of success.”

“We found that most smokers who are switching to e-cigarettes or ‘mild’ cigarettes are not switching completely. These smokers are not stopping their cigarette smoking.”

Lack of clarity

Analysts question whether the study will help resolve, or add to, the lack of clarity on whether e-cigs and vaporizers should be used or recommended as a quit device.

Some studies, including one by the Royal College of Physicians, have claimed e-cigs and vaporizers are up to 95 percent less harmful than traditional cigarettes. The Royal College’s study on traditional cigarettes played a key role in the landmark 1964 surgeon general’s determination on the harmful effects of smoking.

“The CDC has finally acknowledged the popularity of vaping,” said Brad Rodu, a professor of medicine at the University of Louisville and an anti-smoking advocate.

“This study documents that vaping is American smokers’ most popular quit-smoking aid, despite a broad misinformation campaign labeling e-cigarettes as neither safe nor effective.”

Rodu said the study shows that “far fewer smokers use FDA-approved aids, which have been promoted by federal health authorities for many years.”

“Smokers know that, while safe, they are decidedly ineffective.”

Harold Wimmer, president and chief executive of the American Lung Association, said “it’s important to understand that this study ranks cessation methods according to the most common ways people try to quit, (and) not the effectiveness of those methods.”

Wimmer accused e-cig manufacturers of “making unproven quit smoking claims about their products,” even though the major e-cig manufacturers, such as R.J. Reynolds Vapor Co., NuMark and Fontem Ventures, have not made such claims.

“It is imperative that those ready to quit receive accurate information about evidence-based cessation methods and get the support they need to quit for good,” Wimmer said.

Gregory Conley, president of the American Vaping Association, claimed the American Lung Association was “feigning outrage” with the CDC results.

“A prior CDC study showed that among smokers who had successfully quit in the prior year, nearly one-fourth were current users of e-cigarettes, a finding that cuts against the outdated claim that there is no evidence that vapor products help smokers get off combustible tobacco products,” Conley said.

David Sweanor, an adjunct law professor at the University of Ottawa and the author of several e-cig studies, said the CDC report validates the notion that “an increasing number of smokers are using e-cigarettes in their efforts to quit smoking.”

He said he is disappointed that “ideology or financial conflicts may be blinding (the American Lung Association) to the enormous public health gains that can come from giving smokers additional viable options for saving their lives.”

“They need to be facilitating rather than impeding informed choices about those options.”

The low usage of quitlines as a smoking-cessation method could spur a public policy change in some states, analysts said.

In 2011, the Republican-controlled General Assembly abolished the N.C. Health and Wellness Fund after 10 years as part of an attempt at resolving the state’s budget gap at that time. The average annual spending on tobacco-prevention programs had been $17.3 million.

Since 2012, the only annual dedicated state funding toward tobacco-prevention programs has been $1.1 million for the QuitlineNC program.

Wimmer said the association “believes that smokers should have access to all proven quit smoking treatments, and that health plans should not impose barriers like cost-sharing or limit the number of quit attempts per year or lifetime.”

In December, Dr. Vivek Murthy, the U.S. surgeon general, sounded an alarm about e-cigs by saying there’s no safe use of the products for people younger than 25.

“There is confusion around e-cigs and youths; are they safe to use?” Murthy said in a presentation.

“We know enough right now to say that youth and young adults should not be using e-cigarettes or any other tobacco product, for that matter. Electronic cigarettes place a whole new generation at risk for nicotine addiction.”

Murthy acknowledged that his report didn’t aim to resolve the bigger public-health questions of whether e-cigs and vaporizers offer smokers a reduced-risk alternative to traditional cigarettes, or should they be regulated similarly to traditional cigarettes.

Murthy has said that e-cig technology should be embraced if evidence shows it can help smokers who otherwise have trouble quitting their habit.