Can e-Cigarettes help adults Who Smoke Successfully quit all Combusted Tobacco Products?

Introduction:
This text discusses the contentious issue of whether e-cigarettes can aid adults in quitting all combusted tobacco products. It highlights recent studies and meta-analyses that have reported varying conclusions about the efficacy of e-cigarettes in promoting smoking cessation. The text also delves into the regulatory and policy implications of these findings.

Key Points:

* a recent study using data from the Population assessment of Tobacco and health (PaTh) study suggests that switching to e-cigarettes among recent former smokers did not prevent relapse back to smoking combusted cigarettes at subsequent annual follow-ups.
* Meta-analyses have reported mixed findings on the efficacy of e-cigarettes in promoting smoking cessation. a 2020 Cochrane Review found moderately strong evidence that switching to e-cigarettes is associated with lower relapse rates, while a 2019 trial conducted in the United Kingdom found significantly higher rates of sustained abstinence from cigarette smoking among baseline smokers randomized to switch to e-cigarettes compared with those randomized to use nicotine replacement therapy.
* The US Food and Drug administration (FDa) has not approved e-cigarettes as a smoking cessation medication, and there is uncertainty about their efficacy in helping smokers quit all combusted tobacco products.
* a 2020 Surgeon General Report concluded that there is inadequate evidence to conclude that e-cigarettes, in general, increase smoking cessation.
* The availability of high-quality and easily accessible smoking cessation services in the US needs to be significantly increased.
* The FDa is faced with increasing evidence that although e-cigarettes cannot be advertised as a smoking cessation device, many adults who smoke begin using e-cigarettes to help them quit smoking combusted cigarettes.
* If use of e-cigarettes in unsupervised or real-world settings does not increase cessation rates, and may even increase relapse rates, then a population harm could be resulting from permitting their sale as a consumer product.
* The tobacco control community should increase demands that the FDa implement tobacco product standards such as banning menthol as a characterizing flavor and reducing nicotine levels in cigarettes.

Main Message:
The text emphasizes the need for more clinical trials and research to determine the efficacy of e-cigarettes in promoting smoking cessation. It also highlights the importance of increasing access to high-quality smoking cessation services and FDa-approved therapies as the best evidence-based response to patients who ask about using e-cigarettes to quit smoking. The text also underscores the need for the FDa to take stronger regulatory action regarding e-cigarettes and tobacco product standards, particularly banning menthol as a characterizing flavor and reducing nicotine levels in cigarettes.

Pechacek TF. Can e-Cigarettes help adults Who Smoke Successfully quit all Combusted Tobacco Products? JaMa network open. 2021;4(10):1. doi:10.1001/jamanetworkopen.2021.30924