Electronic cigarettes could help people stop smoking and are not associated with any serious side-effects, say researchers

Electronic cigarettes could help smokers kick the habit and do not appear to pose serious side-effects in the short- to mid-term, say researchers.

The findings come from medical research group the Cochrane Collaboration, which has examined the best available evidence on the devices, together with a new study published in the British Medical Journal.



It is estimated that about 2 million smokers in the UK use electronic cigarettes, but their use has proved controversial, with concerns about safety, the effect on health and the possible impact on the uptake of stop-smoking services.

“What we know from the limited evidence we have available, electroniccigarettes that contain nicotine can help people stop smoking,” said Jamie Hartmann-Boyce of the University of Oxford, a co-author of the Cochrane review and a research associate with the Cochrane Tobacco Addiction Review Group.



“In the short- to medium-term we didn’t find any evidence that they were associated with any serious side-effects,” she added.

The advice echoes the finding of the first Cochrane review of the evidence, released in 2014, that looked at 13 studies.



Based on two randomised controlled trials involving more than 660 individuals, the previous review found that nicotine-containing e-cigarettes could increase the chance of smokers quitting, with 9% of smokers using such devices stopping smoking for at least six months, compared with 4% of those using e-cigarettes without nicotine. But it was unclear whether e-cigarettes were more effective than other approaches, such as nicotine patches.

Since then, 11 studies have been included in the review, but no further randomised control trial. The Cochrane committee said there was no evidence of serious side-effects from e-cigarette use over a two-year period.

“The really good news that came out from this version of the review is that we found a lot more studies under way,” said Hartmann-Boyce. “In the next few years hopefully there will be more evidence out there to strengthen our conclusions.”

The review coincides with the publication in the British Medical Journal of a study that suggests that e-cigarettes can increase success rates for smokers who are attempting to quit.

The study looked at survey data from 170,490 individuals aged 16 and older in England between 2006 and 2015, 23% of whom had smoked in the past year, and 21% of whom were current smokers. The study also incorporated data on the use of NHS stop smoking services, which encompassed more than 8 million smokers.

“We estimate for every 10,000 people who used an e-cigarette to quit, approximately 580 would have quit who wouldn’t have quit otherwise,” said Robert West, co-author of the study and Professor of Health Psychology at University College, London.

The authors also estimate that in 2015 e-cigarettes alone may have helped about 18,000 smokers to quit who would not otherwise have quit. What’s more, they say, the devices appear to be linked to a decrease in the use of nicotine replacement therapies on prescription.

But, they add, there was no clear evidence that the devices were prompting more people to give up smoking, or that they had an impact on the use of nicotine replacement therapies bought over the counter, or stop smoking services – an area of interest given a recent decline in use of such services.

“There is no evidence that it is making any difference to the rate at which people are trying to stop – it is increasing the rate at which they succeed,” said West.

John Britton, the director of the UK Centre for Tobacco and Alcohol Studies at the University of Nottingham, said the trend towards a decreasing use of smoking cessation services was likely to be down to a number of factors, including cuts to mass media campaigns and the move of stop smoking services into local authority control. “Stop smoking services have been decimated with the changes to public health funding,” he said.

While Britton cautions that the trials incorporated in the Cochrane review are based on early generation e-cigarettes that deliver very little nicotine, he believes the latest models of e-cigarettes are likely to be much more effective when it comes to quitting.

“The evidence is very clear, smoking kills,” he added. “If you can’t stop smoking, if you can switch to another form of nicotine and that lets you stop smoking then that is great.

“The bottom line is that any smoker who is still smoking tobacco should try an electronic cigarette and try to drop the tobacco completely and do so as quickly as possible.”

Deborah Arnott, the chief executive of health charity Action on Smoking and Health, said: “Taken together, the Cochrane review and BMJ article provide further reassurance that e-cigarettes are not undermining quitting. Indeed, the evidence from England, where smoking prevalence is continuing to decline, is that e-cigarette use is associated with a higher rate of successful quit attempts by smokers.”