In the first head-to-head comparison between e-cigarettes and nicotine patches (NRT) for helping smokers quit, a significant win for e-cigarettes was found in every measured parameter. Led by Dr. Chris Bullen of the University of Auckland, New Zealand, the researchers recruited 657 smokers who said that they wanted to quit. They were randomized into 3 groups: 289 into an e-cigarette group, 295 in the NRT group, and 73 into what they called a "placebo" group: zero-nicotine e-cigarettes. The selected marketed e-cigarette delivered a fairly low-level nicotine dose, 16 mg., while the NRTs were 21 mg. per daily patch. The study period was for 13 weeks, and the primary outcome measured was abstinence from tobacco confirmed by carbon monoxide breath testing at 6 months follow-up.
The results showed a clear win for the e-cigarette group, with 7.3 percent of that group smokefree, while the NRT group had a success rate of 5.8 percent (the placebo group had a 4.1 percent abstinence rate at 6 months). Due to the unexpectedly low success rate among the entire group, these results, while demonstrating a clear positive trend for e-cigarettes, did not achieve statistical significance. There was no advantage to any of these treatments in terms of adverse effects.
Another important finding was the likelihood of staying on the treatment throughout the study period, even among those who did not quit completely, and the reduction of cigarette use in those non-quitters. Among those who had not managed to quit after six months, cigarette consumption was markedly reduced in the nicotine e-cigarettes group, compared to the patches and placebo groups: well over half (57%) of the participants in the e-cigarettes group had reduced their daily consumption of cigarettes by at least half after six months, compared to just over two fifths (41%) of the patches group.
In both the nicotine and placebo e-cigarettes groups, a third of participants were still using the devices after six months, compared to under one in ten (8%) of those in the patches group. When asked whether they would recommend their allocated product to a friend one month after finishing the course, around 9 out of 10 participants in both the e-cigarettes and the placebo groups said they would, compared to just over half (56%) in the patches group.
One of the study's co-authors, Dr. Murray Laugesen of Health New Zealand in Christchurch (and the author of ACSH's soon-to-be-released study, "Nicotine and Health"), had this to add: "Nine out of 10 smokers using e-cigarettes were enthusiastic about them and would recommend them to a friend. This is in contrast to medicinal nicotine products. The results obtained were despite the fact that the e-cigarette brand we used for the trial which began 2 years ago was low in nicotine compared to today's brands. If we repeated the trial with today's brands, smokers would have obtained three times as much nicotine as they did in this trial, probably creating an even stronger result. In sum, this world-leading Auckland NZ trial published in the Lancet today shows e-cigarettes definitely help people stop smoking, being at least as effective as nicotine patches (personal communication).
ACSH's Dr. Gilbert Ross had this comment: "While this study certainly shows that e-cigarettes, or 'vaping,' are at least equivalent to NRT patches which are stubbornly touted by the authorities for quitting. I must point out that the 13-week study period is completely foreign to the usual use of e-cigarettes when replacing smoking. Smokers don't use e-cigarettes for a few weeks or months to remain smoke-free; they stay on them long-term, and I strongly believe that if this study was aimed at that type of cessation behavior, the results would have been much more decisive. Hopefully that study is being done now, perhaps in multiple centers."
