Electronic Cigarettes Efficacy and Safety at 12 Months: Cohort Study

Introduction:
This article reports the results of a prospective cohort study examining the safety and efficacy of electronic cigarettes (e-cigarettes) as a tool for smoking cessation. The study directly compares users of e-cigarettes only, smokers of tobacco cigarettes only, and smokers of both. The study is part of a larger 5-year study, but the results of the 12-month follow-up are being reported due to the urgency of data to support policies on electronic smoking.

Key Points:

* The study included adults who were smokers of tobacco cigarettes, users of e-cigarettes, or dual smokers.
* Data was collected through a structured questionnaire on smoking habits, previous and current diseases, lifestyle behavior, and quality of life.
* The primary outcome was the percentage of subjects reporting sustained (30 days) smoking abstinence from tobacco smoking at 12 months.
* Other outcomes were the proportion of quitters from all types of smoking (tobacco and e-cigarettes), the number of tobacco cigarettes smoked, self-reported health, and serious adverse events.
* At 12 months, 61.9% of the e-smokers were still abstinent from tobacco smoking, while 20.6% of the tobacco smokers and 22.0% of the dual smokers achieved tobacco abstinence.
* E-smokers showed a minimal but significantly higher increase in self-rated health than other smokers.
* There were no significant differences in self-reported serious adverse events between the groups.

Main Message:
The study suggests that the use of e-cigarettes alone may facilitate quitters remaining so, if the safety of e-cigarettes is confirmed in long-term evaluations. However, adding e-cigarettes to tobacco smoking did not facilitate smoking cessation or reduction. Therefore, e-cigarettes should not be used as a tool to quit smoking in combination with tobacco cigarettes. The study also highlights the need for more research on electronic smoking safety, which remains the most important issue from a public health perspective.

Manzoli, Lamberto, Maria Elena Flacco, Maria Fiore, Carlo La Vecchia, Carolina Marzuillo, Maria Rosaria Gualano, Giorgio Liguori, et al. “Electronic Cigarettes Efficacy and Safety at 12 Months: Cohort Study.” Edited by Raymond Niaura. PLOS ONE 10, no. 6 (June 10, 2015): e0129443. https://doi.org/10.1371/journal.pone.0129443.