|
 The conclusion, issued by the U.S. Preventive Services Task Force (USPSTF)
today as a part of updated recommendations on smoking cessation,
adds to an emerging consensus in the medical community that
e-cigarettes come with too many unknowns for them to be recommended
to current smokers looking to kick the habit.
“There is not enough evidence to evaluate the effectiveness, safety
or benefits and harms of using e-cigarettes to help people quit
smoking,” said Dr. Francisco Garcia, a task force member and
researcher at the University of Arizona.
Battery-powered e-cigarettes typically feature a glowing tip and a
heating element that turns liquid nicotine and other compounds into
a cloud of vapor that users inhale.
While tobacco control advocates fear that e-cigarettes may give rise
to a new generation of nicotine addicts who eventually transition to
conventional cigarettes, some small studies have suggested the
devices might benefit the health of people who already smoke.
An international analysis of published research by the Cochrane
Review in December concluded the devices could help smokers quit but
said much of the existing research on e-cigarettes was thin.
The USPSTF, a government-backed independent organization that
reviews medical evidence, last updated its tobacco cessation
guidelines in 2009. Then, as now, the task force found too little
evidence to weigh in for or against e-cigarettes as a cessation aid.
These guidelines are widely used to determine whether insurance will
pay for screenings and treatments and are widely followed by primary
care physicians.
“The task force recommends that clinicians direct patients who smoke
tobacco to other cessation interventions with established
effectiveness and safety,” Garcia said by email. “Many studies show
that combinations of behavioral interventions or pharmacotherapies
can help the most.”
Carrie Patnode, lead author of the research review USPSTF used as
the basis for its updated guidelines, said that to date, just two
large trials assessing e-cigarettes for smoking cessation met the
gold standard for medical research, i.e., randomly assigning some
patients to receive the treatment and others to receive a placebo or
alternatives.
[to top of second column] |
One of the two trials involved about 650 smokers and found no
significant difference in smoking cessation after six months for
e-cigarettes containing liquid nicotine, e-cigarettes without
nicotine, or nicotine patches.
The second trial followed 300 smokers for one year and found
e-cigarettes containing nicotine to be slightly better than the
devices without nicotine cartridges, with cessation rates of 11
percent and 4 percent, respectively.
Both of these trials were conducted using older models of
e-cigarettes, one of which is no longer available, and both studies
had large numbers of participants drop out before the end.
The review, along with the task force recommendations, was published
today in the Annals of Internal Medicine.
One challenge that faces doctors and scientists who assess
e-cigarettes is the sheer variety of options, all of which may
contain different amounts of nicotine, chemicals and additives that
might impact the safety and effectiveness of the devices as
cessation aids.
“There is a large variation in the devices and cartridge fluids
publicly available and new products are rapidly entering the
market,” Patnode, a research associate at Kaiser Permanente’s Center
for Health Research in Portland, Oregon, said by email. “It is clear
that more data on both the benefits and harms of these products –
from well-designed trials – is needed.”
SOURCE: http://bit.ly/1i46lF7 Annals of Internal Medicine, online
September 21, 2015.
[© 2015 Thomson Reuters. All rights
reserved.] Copyright 2015 Reuters. All rights reserved. This material may not be published,
broadcast, rewritten or redistributed.
 |
