Introduction
Smoking is considered one of the unhealthy habits that harm nearly every organ of the body, causing general health deterioration in the smoker. According to the CDC, smoking is among the US leading causes of death, causing more than 400,000 deaths annually (Elimination—Worldwide, 2022). Clinical therapies such as Nicotine Replacement Therapy (NRT) have been developed to assist cigarette addicts in quitting smoking (Leelavathi, 2019). This paper aims to answer the PICOT question; “In smokers aged 25-65 years who use nicotine (P), are electronic cigarettes (I) as compared to smoking cessation therapies (C) more effective at leading to smoking cessation (O) over one year (T)?” This paper analyzed two studies on the effectiveness of e-cigarettes: Peter Hajek et al., research “Randomized trial of e-cigarettes versus nicotine-replacement therapy” retrieved from “The New England Journal of Medicine” database and Smith Myers et al., research “E‐cigarettes versus nicotine replacement treatment as harm reduction interventions for smokers who find quitting difficult” retrieved from “Wiley Online Library” database.
Study 1
Peter Hajek et al., research “Randomized trial of e-cigarettes versus nicotine-replacement therapy”
Peter Hajek et al. wanted to prove how efficiently e-cigarettes facilitated tobacco cessation compared to nicotine replacement therapy. The study involved a random sampling of adult patients at a UK National Health Service. The participants were required to embrace a stop-smoking intervention of their choice (Hajek et al., 2019). They were supposed to select either nicotine-replacement products such as gums, patches, or a combination of products for up to 3 months, or a refillable e-cigarette package with an 18mg bottle of e-liquid with the option of purchasing their preferred e-liquids of other flavors. The treatment method employed by the researcher involved behavioral monitoring for at least one month. The main research result involved abstaining from smoking for at least one year. Some participants lost track of the program and were not considered abstinent. The secondary outcomes of the study involved observations of how the participants responded to the treatments, including reports of respiratory symptoms.
The study results were categorized into two groups: the e-cigarette and the nicotine-replacement groups. The analysis of the results was based on the observations of 886 participants. After analysis of the results, it was established that the e-cigarette group recorded a one-year abstinence rate of 18%, while the nicotine-replacement participants recorded an abstinence of 9.9% (Hajek et al., 2019). About 80% of the participants (63 of 79) in the e-group with one-year abstinence used their assigned products for 52 weeks compared to 9% of the participants (4 of 44) in the nicotine-replacement group (Hajek et al., 2019). The participants from the e-cigarette group also noted a significant reduction in the respiratory symptoms of smoking, such as persistent coughing and production of phlegm within 52 weeks, compared to the nicotine-replacement group (Hajek et al., 2019). No notable difference was reported between the two groups regarding breathing problems and wheezing.
The results established that the use of e-cigarettes was a more effective approach than nicotine-replacement therapy in facilitating smoking cessation. E-cigarettes alleviated tobacco withdrawal symptoms more efficiently than nicotine therapy. However, users of e-cigarettes were likely to continue using the cigarettes for a considerable period. E-cigarette users were also at risk of suffering mild mouth and throat irritation, while nicotine-replacement therapy caused nausea. It was also established that e-cigarette users experienced reduced respiratory infections.
Study 2
Smith Myers et al., research “E‐cigarettes versus nicotine replacement treatment as harm reduction interventions for smokers who find quitting difficult”
According to Smith Myers et al., 135 smokers of 40 median age were randomly chosen to determine how effective e-cigarettes were compared to nicotine-replacement therapy in reducing smoking among smokers who were previously unable to quit smoking. The participants chose either nicotine-replacement therapy of their preference for an eight-week supply program or an e-cigarette starter pack with the recommendations of purchasing e-liquids of their preferred strength and flavors (Myers et al., 2022). The effectiveness of the two interventions was measured based on the carbon monoxide readings of the participants. The study’s primary outcome was based on at least 50% reduced smoke intake for six months (Myers et al., 2022). The main secondary outcome is based on persistent abstinence for the same period.
The research results indicated that the e-cigarette study arm achieved 26% sustained smoke reduction and cessation compared to the 6% achieved by the nicotine-replacement group. The e-cigarette also recorded a 19.1% consistent abstinence compared to a 3.0% by the nicotine-replacement group for six months (Myers et al., 2022). The e-cigarette study arm also reported 47% consistent use of the product allocated compared to the 10% recorded by the nicotine-replacement group for six months (Myers et al., 2022). This showed how appealing e-cigarettes were to their users than nicotine-replacement therapy.
The researcher concluded that e-cigarettes effectively reduced the rate of smoking among smokers who had unsuccessfully attempted to quit. E-cigarettes reduced carbon monoxide intake by at least 50% and had greater chances of influencing smoking cessation (Myers et al., 2022). Nicotine-replacement therapy was more effective when intensive face-to-face behavioral monitoring than when the products were issued over the counter. It was also established that smokers were more likely to persevere using e-cigarettes than nicotine-replacement therapy. However, using e-cigarettes was found to contain more long-term health effects for the users than nicotine-replacement therapy.
Conclusion
In conclusion, the two studies indicate that e-cigarettes are more effective in influencing smoking cessation than the use of smoking therapies such as nicotine-replacement therapy. However, the effectiveness of smoking therapies required close monitoring of the patients. The efficacy of e-cigarettes was mainly short-term but offered long-term health risks to the patients. It also provided another form of addiction where patients who use e-cigarettes are likely to continue using the product for the long term compared to the other therapies.
References
Elimination—Worldwide, N. T. (2022). Tobacco Product Use among Adults—the United States, 2020.
Hajek, P., Phillips-Waller, A., Przulj, D., Pesola, F., Myers Smith, K., Bisal, N. & McRobbie, H. J. (2019). A randomized trial of e-cigarettes versus nicotine-replacement therapy.New England Journal of Medicine, 380(7), 629-637.
Leelavathi, L. (2019). Nicotine Replacement Therapy for Smoking Cessation-An Overview. Indian Journal of Public Health Research & Development, 10(11).
Myers Smith, K., Phillips‐Waller, A., Pesola, F., McRobbie, H., Przulj, D., Orzol, M., & Hajek, P. (2022). E‐cigarettes versus nicotine replacement treatment as harm reduction interventions for smokers who find quitting difficult: A randomized controlled trial.Addiction, 117(1), 224-233.