More than a third of smokers who completed a pilot study of e-cigarettes as a smoking cessation aid quit smoking.

A total of 1,022 smokers aged 18-84, average 45 years, who expressed a desire to quit were enrolled in the study in 2018, from a deprived area in the North West of England where smoking prevalence was high. Participants were supplied with an e-cigarette and liquid through community and pharmacy smoking cessation services which also provided advice and guidance on stopping smoking. 

The primary outcome was a successful quit, corroborated by carbon monoxide (CO) readings, four weeks after the quit date. The secondary outcomes were the number of cigarettes smoked and CO readings.

Of the 1,022 smokers initially registered, 670 were still engaged with the programme by week 2 and 614 by week 4. It was assumed that the remaining 408 continued to smoke although some may have quit and not wanted to continue on the programme. 

A total of 383 out of 614 stopped smoking tobacco, a quit rate of 37%. Quit rates were lower in older individuals (55-64 years) compared with younger individuals (18-24 years) and also in those who were unemployed or in the most deprived quintile. The quit rate was not affected by the quantity of cigarettes smoked at baseline or whether the stop smoking service was community or pharmacy based.

Of those who continued to smoke the reported number of cigarettes smoked had fallen from an average of 19.1/day to 8.7/day. This was accompanied by significant reductions in CO levels.

The authors point out that the fact that so many smokers had given up by the 2-week review emphasises the need to offer as much support as possible during this initial period.

They conclude: ‘The conservative estimate of smoking cessation [37%] demonstrated that community and pharmacy providers were able to at least match (if not slightly exceed) NICE smoking cessation targets [35%].’

This was a pilot study and did not address the issue of continued nicotine use in those who quit tobacco and the possible adverse health effects. Also, the gender of participants was not stated.

The authors recommend further research to determine whether e-cigarette users are more likely to reduce their overall nicotine consumption in the longer term. 

Dr Peter Saul