The following is a summary of “Electronic Nicotine-Delivery Systems for Smoking Cessation,” published in the February 2024 issue of Psychiatry by Auer et al.

Researchers conducted a retrospective study to assess the effectiveness and safety of electronic nicotine-delivery systems, commonly known as e-cigarettes, as aids for tobacco smokers attempting to quit, requiring comprehensive evidence.

They conducted an open-label, controlled trial where adults smoking at least five tobacco cigarettes daily and desiring to quit were randomly allocated to either an intervention group, receiving complimentary e-cigarettes and e-liquids along with standard smoking-cessation counseling and optional nicotine-replacement therapy, or a control group, receiving standard counseling and a voucher usable for any purpose, including nicotine-replacement therapy. The primary outcome assessed was biochemically validated continuous smoking abstinence at 6 months, with secondary outcomes including self-reported tobacco and nicotine abstinence, respiratory symptoms, and adverse events.

The results showed that of 1,246 randomized participants, 622 were assigned to the intervention group and 624 to the control group. The percentage of participants achieving validated continuous abstinence from tobacco smoking was 28.9% in the intervention group and 16.3% in the control group (relative risk, 1.77; 95% CI, 1.43 to 2.20). In terms of abstaining from smoking in the 7 days before the 6-month visit, 59.6% of the intervention group and 38.5% of the control group were successful, while those abstaining from any nicotine use were 20.1% in the intervention group and 33.7% in the control group. Serious AEs occurred in 25 participants (4.0%) in the intervention group and 31 (5.0%) in the control group; adverse events occurred in 272 participants (43.7%) and 229 participants (36.7%).

Investigators concluded that adding e-cigarettes to counseling may boost smoking cessation success, but further research is needed to confirm long-term benefits and potential risks.

Source: nejm.org/doi/full/10.1056/NEJMoa2308815