Practice Therapeutics

Electronic cigarettes for smoking cessation

BMJ 2018; 360 doi: https://doi.org/10.1136/bmj.j5543 (Published 17 January 2018) Cite this as: BMJ 2018;360:j5543
  1. Jamie Hartmann-Boyce, senior researcher1,
  2. Rachna Begh, NIHR postdoctoral research fellow1,
  3. Paul Aveyard, professor of behavioural medicine1
  1. 1Nuffield Department of Primary Care Health Sciences, Radcliffe Observatory Quarter, University of Oxford, Oxford UK OX2 6GG, UK
  1. Correspondence to: J Hartmann-Boyce Jamie.hartmann-boyce{at}phc.ox.ac.uk

What you need to know

  • Electronic cigarettes (e-cigarettes) were originally designed as a smoking cessation aid, and the limited evidence available suggests e-cigarettes containing nicotine may help people stop smoking

  • Evidence suggests e-cigarettes are considerably safer than traditional cigarettes

  • The technology used in e-cigarettes has evolved considerably over time, and newer devices are typically better at delivering nicotine, which might enhance effectiveness

A 42 year old electrician has tried to stop smoking several times, including with the aid of pharmacotherapy and behavioural support. He asks you about using electronic cigarettes (e-cigarettes). His work partner stopped smoking a year ago and is still using e-cigarettes now. He has heard that e-cigarettes are as damaging as the real things and worries that if he ends up addicted to e-cigarettes he’ll not have gained anything.

About 60% of current adult smokers in Great Britain have tried electronic cigarettes (e-cigarettes), and 18% are current e-cigarette users.1 In England, over 40% of people who try to stop smoking do so with the aid of e-cigarettes.2 About 52% of current e-cigarettes users are former smokers.1 Some people who stop smoking with an e-cigarette are still using e-cigarettes a year later.1 In this article we look at whether e-cigarettes help people who smoke to cut down and stop smoking, what are the health risks from e-cigarette use, and how these compare with smoking.

Cigarette and nicotine addiction

Most people who smoke cigarettes are addicted, and the main vehicle of that addiction is nicotine. When stopping smoking, people experience cravings for cigarettes, which drives return to smoking. These cravings for smoking are less intense when nicotine is substituted; thus replacing nicotine from sources other than cigarettes can facilitate achieving abstinence.

Transferring from cigarettes to other nicotine delivery devices, such as nicotine replacement therapy (NRT) or e-cigarettes, can transfer cigarette addiction to nicotine addiction. …

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