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• 29295

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  ES13 - Global Political, Legal, and Financial Strategies For Tobacco Control (ID 16)

  • Event: WCLC 2019
  • Type: Educational Session
  • Track: Prevention and Tobacco Control
  • Presentations: 1
  • Now Available
  • Moderators:Desmond Carney, Esteve Fernandez
  • Coordinates: 9/08/2019, 15:15 - 16:45, Vienna (2016)

  • 29299

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    ES13.04 - Comparing ENDS to NRT for Smoking Cessation (Now Available) (ID 3227)

    15:15 - 16:45  |  Presenting Author(s): Hayden McRobbie
    • Abstract
    • Presentation
    • Slides

    Abstract
    

    Comparing ENDS to NRT for smoking cessation

    For people who smoke, quitting completely is associated with numerous benefits for current and future health. There are a range of effective stop smoking medicines that can increase long-term abstinence rates, compared with unassisted quitting. However, these rates remain low (eg. < 25%), with most people relapsing within 3-6 months. Over the past decade electronic nicotine delivery systems (ENDS), more commonly known as e-cigarettes or vaporisers, have become increasing popular among smokers, and in some countries are now the most commonly used tool to aid smoking cessation.

    Until recently the evidence for the effectiveness of ENDS in helping people stop smoking has been limited, with only two published randomised controlled trials (RCTs). There are now four RCTs; three show the superiority of nicotine containing ENDS, compared to those without nicotine, in helping smokers quit for at least six months and one found vaping to be associated with higher 12-month quit rates than nicotine replacement therapy (NRT; 18% vs. 10%; RR=1.83; 95% CI: 1.30-2.58). The difference in quit rates may have been due to ENDS providing greater withdrawal relief, providing better subjective effects, and smokers being able to self-titrate their nicotine intake. Among 12-month ex-smokers, rates of ongoing ENDS use were significantly higher than ongoing NRT use. This could raise concern if long-term ENDS use is associated with health risk. Alternatively, this could be beneficial if it prevents relapse and so risk-benefit analysis is required.

    Health professionals are often asked by their patients if ENDS can help aid quitting smoking and if they are safe. There are data to show that ENDS are an effective smoking cessation aid, and some evidence to support their superiority over NRT. Current data suggest that health risks associated with ENDS use are substantially less, overall, than risks associated with smoking tobacco. However, the health risks associated with long-term ENDS use remain unknown, and long-term cohort studies, especially regarding lung health in vapers, are needed. To mitigate concern over unknown health risks associated with long-term vaping ex-smokers can be advices to stop vaping as soon as they feel they are safe from relapse to smoking.

    This presentation will summarise the evidence of effectiveness of ENDS for smoking cessation, and provide an overview of possible health risks, to enable health professionals to better advise their patients who ask about using ENDS.

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