E-cigarettes might not be as useful in quitting smoking as the news yesterday suggests.
The headlines on Google all say pretty much the same thing: E-cigarettes help smokers quit. That was clearly the message of the press release from the journal Addiction, which said, "People attempting to quit smoking without professional help are approximately 60% more likely to report succeeding if they use e-cigarettes than if they use willpower alone or over-the-counter nicotine replacement therapies such as patches or gum."
But is that correct? "It's a big stretch to say that the e-cigarette works better than the nicotine patch," said Frank Leone, director of the University of Pennsylvania's Comprehensive Smoking Treatment Program, who was not part of the study.
That comment came in a post by MedPageToday's Sarah Wickline, under the rubric "HypeWatch." The problem, she wrote, was that "the study design casts doubt" on the conclusion that E-cigs are so effective in helping smokers quit.
Wickline was not the only one to question the study. Deborah Kotz began her piece at The Boston Globe with, "As a health reporter, I hate covering flip-flopping studies like a March finding that electronic cigarettes don’t help smokers quit and a new British study finding that they do." She comes down mostly on the side of the new study, but concludes by saying that E-cig makers, which include tobacco companies, are making claims about smoking cessation that are not yet proven, and that such claims shouldn't be allowed.
Sabrina Tavernese at The New York Times wrote that the evidence that E-cigarettes helped smokers quit was "encouraging but not definitive."
[Interestingly, I came across an NPR story that ran Tuesday saying that health insurers might be able to raise rates for E-cig smokers just as they do for cigarette smokers. The details are complicated, but it suggests that health insurers are not terribly fond of E-cigarettes.]
In her HypeWatch post, Wickline engaged in a little media criticism. She wrote:
Media outlets, one of which broke the embargo this morning, have been accurately reporting the study's findings; however, very few consulted outside sources or discussed flaws in the study's design before aggrandizing the benefits of e-cigarettes for smoking cessation.
"The clue that something's wrong or inconsistent is the idea that only 10% were able to quit smoking using the patch. That's on the low side. And that people who used nothing did better than those who used the patch is inconsistent with prior studies," Leone said.
Wickline noted, among other things, that the new study relied on smokers' reports of abstinence, with no testing of blood or urine to validate those self-reports.
And she made what to me is a key observation: Tobacco companies are diving into the E-cigarette market. If E-cigarettes help people quit smoking–and the industry has vast resources to conduct its own private studies, so it probably knows–why would cigarette companies be selling them?
She quotes Richard Hurley, deputy managing editor at the BMJ, who says, "This is not a consumer movement, but the full onslaught of corporate capital in hot pursuit of a profitable opportunity."
E-cigarette users take note.
-Paul Raeburn
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