A Randomized Trial of E-Cigarettes versus Nicotine-Replacement Therapy

Introduction:
This text presents the results of a randomized trial comparing the effectiveness of e-cigarettes and nicotine-replacement therapy for smoking cessation. The study was conducted among adults seeking help to quit smoking and combined with face-to-face behavioral support. The trial aimed to evaluate the 1-year efficacy of refillable e-cigarettes as compared with nicotine replacement.

Key Points:

* The trial was a two-group, pragmatic, multi-center, individually randomized, controlled trial.
* Participants were randomly assigned to either the e-cigarette group or the nicotine-replacement group and received the same multisession behavioral support.
* The primary outcome was 1-year sustained abstinence, calculated in accordance with the Russell Standard.
* The rate of sustained 1-year abstinence was 18.0% in the e-cigarette group and 9.9% in the nicotine-replacement group.
* Participants in the e-cigarette group were more likely to use their assigned product at 52 weeks than those in the nicotine-replacement group.
* The e-cigarette group reported greater declines in the incidence of cough and phlegm production from baseline to 52 weeks than did the nicotine-replacement group.
* There were no significant between-group differences in the incidence of wheezing or shortness of breath.

Main Message:
The main message of the text is that e-cigarettes were more effective for smoking cessation than nicotine-replacement therapy when both products were accompanied by behavioral support. The trial provides important evidence for regulators and healthcare providers to consider when making recommendations for smoking cessation. However, the long-term health effects of e-cigarette use still need to be studied, and regulatory measures should be in place to ensure the safety and quality of e-cigarettes.

Hajek, Peter, Anna Phillips-Waller, Dunja Przulj, Francesca Pesola, Katie Myers Smith, Natalie Bisal, Jinshuo Li, et al. “A Randomized Trial of E-Cigarettes versus Nicotine-Replacement Therapy.” New England Journal of Medicine 380, no. 7 (February 14, 2019): 629–37. https://doi.org/10.1056/NEJMoa1808779.