Research has shown that nicotine replacement therapies such as the patch, gum lozenges and nasal spray are only 25 percent effective in smoking cessation within the first year of use.
Jed Rose, Director of the Duke Center for Smoking Cessation, thinks the use of e-cigarettes, or electronic nicotine delivery systems (ENDS) could be a better way to quit smoking.
Rose spoke Tuesday in a session sponsored by the Center on Addiction and Behavior Change.
He said nicotine replacement is delivered at a slower rate and a lower dose than in actual cigarettes, so it fails to curb craving among smokers. Replacements also don’t replicate one of the main sensory behaviors of smoking: inhalation.
Rose discussed a study in which he and his colleagues anesthetized participants’ airways to see if they could detect the smoke, while keeping the same dose of nicotine to the brain. When participants couldn’t feel the smoke as much, there were more cravings for cigarettes and less satisfaction.
They’ve also found that replacement treatments, when given on a temporary basis of just one year, often resulted in relapse.
So what does an e-cigarette actually do? The battery of this electronic cigarette heats an oil that vaporizes the nicotine with a substance called propylene glycol. The gas is released and condenses immediately into a cloud of smoke.
Why is the e-cigarette safer? It’s the combustion products in smoke, rather than the nicotine, that are responsible for most smoking-related disease. Rose cited the 2010 Surgeon General’s Report that backs up this claim that nicotine itself is not responsible for cardiovascular problems or cancers.
Rose thinks that e-cigarettes could be the best of both worlds, allowing smokers the same sensory effects they enjoy, while possibly avoiding other health hazards of regular cigarette smoking.
Rose also addressed concerns about formaldehyde being present in e-cigarettes. He says this is rare, and only occurs with e-cigarettes that have higher voltages which causes overheating to occur. While there is evidence from two trials that the new devices help smokers to stop smoking long-term compared with placebo, unfortunately, very few studies have looked at this issue. Rose also shares concerns that the new product could be picked up by youth who wouldn’t normally smoke cigarettes, or serve as a gateway between e-cigarettes and real ones.
In the end, however, he thinks this product has the potential to be highly effective in treating addiction, and hopes it will be evaluated further.
“The agency that has to sort through this is the FDA,” he said. “They have to prove that it will help society as a whole. It has to benefit the health of the population.”