The new findings are "pretty consistent with what we've seen before in this area in terms of demonstrating that people who experiment with electronic cigarettes, even if they swear at baseline that they would never smoke regular cigarettes, are at much more risk of transitioning to regular cigarettes", said Dr. Brian Primack, director of the Center for Research on Media, Technology and Health at the University of Pittsburgh in Pennsylvania.
The problem with translating drug research to a consumer product like e-cigarettes is that the strict protocols of a drug trial (all participants use a certain drug at a certain dose and interval) may not translate to products that succeed by offering a wide range of possibilities to users.
It all contributes to a confusing picture of what is healthy and what isn't - and comes as advocates claim misinformation about vaping is widespread and harmful to public health.
Another concern is vaping's popularity with youths, as America grapples with a 78 percent surge in e-cigarette use among high school students from 2017-2018, which the US Surgeon General has described as an "epidemic". "E-cigarettes were more effective for smoking cessation than nicotine-replacement therapy, when both products were accompanied by behavioral support", the researchers wrote in their study, which was published on January 30.
The e-cigarette group were nearly twice as successful, with an abstinence rate of 18%.
The World Health Organization is concerned about cancer-causing chemicals in the devices and the European Union believes e-cigarettes may act as a "gateway" to tobacco.
Added Weaver: "The results of this study indicate that under these conditions, e-cigarettes improved the likelihood of quitting smoking".
Juul is one of the most popular e-cigarette companies, and many University of OR students said that it's nearly impossible to escape the Juul epidemic on campus because they see them everywhere. Nine percent of the participants in the other group were still using gums and other nicotine-replacement products. Peter Hajek of Queen Mary University of London describes a randomized trial comparing smokers attempting to quit using a vaping product with others using NRT.
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Ian Armitage was skeptical about e-cigarettes as a way to stop smoking, saying he tried vaping several years ago but gave it up after experiencing twitching and shakes from nicotine withdrawal.
Borrelli also warns people not to look at e-cigarettes as a magic cure to quit smoking tobacco cigarettes. The participants, who sought NHS' help to quit smoking, were all given behavioral support.
The treatment groups also recorded their side effects.
Martin Dockrell, tobacco control lead at Public Health England, said: "All stop-smoking services should welcome smokers who want to quit with the help of an e-cigarette".
The delay has come under intense criticism amid an explosion in teenage vaping, driven chiefly by devices like Juul, which resembles a flash drive.
Myth #1: E-cigarettes give you popcorn lung. The other thing it does is show that the magnitude of risk is even higher for those at low risk for using cigarettes.
Because people had known which treatment they had received - as opposed to being "blinded" as they are in most randomised controlled trials - it was possible participants may have perceived nicotine replacements as an inferior option and put less effort into quitting, the authors said.
FDA Commissioner Scott Gottlieb proposed measures in November for restricting sales of most flavored e-cigarettes and limiting them to specialized shops and online retailers that can verify a purchaser's age. "One reason is that there are over 400 brands of e-cigarettes and they vary substantially".