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Home > E-cigarettes versus nicotine replacement treatment as harm reduction interventions for smokers who find quitting difficult: randomized controlled trial.

Myers Smith, Katie and Phillips-Waller, Anna and Pesola, Francesca and McRobbie, Hayden and Przulj, Dunja and Orzol, Marzena and Hajek, Peter (2021) E-cigarettes versus nicotine replacement treatment as harm reduction interventions for smokers who find quitting difficult: randomized controlled trial. Addiction, Early online, . (In Press) doi: 10.1111/add.15628.

External website: https://onlinelibrary.wiley.com/doi/10.1111/add.15...

BACKGROUND AND AIMS: The majority of smokers accessing the current best treatments continue to smoke. We aimed to test if e-cigarettes (EC) compared with nicotine replacement treatment (NRT) can help such smokers to reduce smoking. The design was a randomized controlled trial of EC (n = 68) versus NRT (n = 67) with 6-month follow-up, which took place in a stop smoking service in London, UK with a total of 135 smokers (median age = 40 years, 51% male) previously unable to stop smoking with conventional treatments.

INTERVENTIONS: Participants received either NRT of their choice (8-week supply) or an EC starter pack and instructions to purchase further e-liquids of strength and flavours of their choice themselves. Products were accompanied by minimal behavioural support.

MEASUREMENTS: Participants who reported that they stopped smoking or reduced their daily cigarette consumption by at least 50% at 6-month follow-up were invited to provide a carbon monoxide (CO) reading. The primary outcome was biochemically validated reduction in smoke intake of at least 50% at 6 months and the main secondary outcome was sustained validated abstinence at 6 months. Drop-outs were included as 'non-reducers'.

FINDINGS: Validated smoking reduction (including cessation) was achieved by 26.5 versus 6.0% of participants in the EC and NRT study arms, respectively. Sustained validated abstinence rates at 6 months were 19.1 versus 3.0%. Product use was high and equal in both study arms initially, but at 6 months allocated product use was 47% in the EC arm versus 10% in the NRT arm, respectively. Adverse events were minor and infrequent.

CONCLUSIONS: In smokers unable to quit using conventional methods, e-cigarettes were more effective than nicotine replacement therapy in facilitating validated long-term smoking reduction and smoking cessation when limited other support was provided.


Item Type
Article
Publication Type
International, Open Access, Article
Drug Type
Tobacco / Nicotine
Intervention Type
Drug therapy, Treatment method
Date
29 June 2021
Identification #
doi: 10.1111/add.15628
Volume
Early online
EndNote

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