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The FDA's Refusal to Promote E-Cigarettes is a Public Health Crisis
03 February 2019, 10:45 | Silvia Roy
At the end of the year, almost 80 percent of the vapers were still using e-cigarettes, while only 9 percent of the participants in the other group continued with the nicotine replacement therapy.
In the newstudy, researchers tracked almost 900 middle-age smokers who were randomly assigned to receive either e-cigarettes or nicotine replacement products, including patches, gums and lozenges.
However, people who switched to vaping were far more likely to keep vaping, indicating they may have exchanged one nicotine delivery device for another, without ever beating their addiction.
But two editorials in the same publication threw some cold water on the trial's results.
"We know that patients are asking about e-cigarettes and many doctors haven't been sure what to say, " said Dr. Nancy Rigotti, a tobacco treatment specialist at Harvard Medical School who was not involved in the study.
Przulj is a research health psychologist with the Health and Lifestyles Research Unit at Queen Mary University of London. That was a reversal of a hands-off approach to e-cigarettes Gottlieb took in 2017 that was followed by a 75 percent rise between 2017 and 2018 in use of e-cigarettes by children and teens.
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"All stop smoking services should welcome smokers who want to quit with the help of an e-cigarette".
'Although a large number of smokers report that they have quit smoking successfully with the help of e-cigarettes, health professionals have been reluctant to recommend their use because of the lack of clear evidence from randomised controlled trials. To objectively measure their progress, they also had their breathing levels of carbon monoxide (a common toxin in cigarette smoke that lingers in exhaled air) monitored.
Funding for the study came from the British government, which has embraced e-cigarettes as a potential tool to combat smoking through state-run health services.
The study was funded by the National Institute for Health Research and Cancer Research UK. "Both e-cigarettes and nicotine-replacement products were perceived to be less satisfying than cigarettes", Hajek et al. write. In comparison, only about 10 percent of those who were given nicotine replacement therapy quit the habit.
Counseling and behavioral support were offered once a week for at least a month.
Findings from the nationally representative study, published online in JAMA Network Open, add to the growing evidence linking e-cigarette use to an increased risk for initiating cigarette smoking among youth, especially among low-risk teens.
E-cigarettes are nearly twice as effective at helping smokers quit as nicotine replacement therapies such as lozenges and patches, according to a new study that immediately stoked the debate over whether e-cigarettes are an important smoking-cessation tool or a health menace.
"This groundbreaking NIHR-funded study provides clear evidence that e-cigarettes are nearly twice as effective as nicotine replacement therapy for helping smokers to quit".
Electronic cigarettes, which have been available in the USA since about 2007 and have grown into a $6.6 billion-a-year industry, are battery-powered devices that typically heat a flavored nicotine solution into an inhalable vapor. The researchers said one reason e-cigarettes were found to be more effective may be that they allow for better tuning of nicotine doses to individual needs.
Philip Morris International Inc., whose sister company Altria Inc.is seeking FDA approval to sell its "heat-not-burn" IQOS tobacco device, said a balance must be struck between seeking to prevent teens from using nicotine products and helping to move adult smokers away from cigarettes.
Because the PATH study data was observational, the researchers admitted their analysis is unable to "establish causal relations or rule out the possibility of residual confounding by underlying risk-taking propensities".
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