The first electronic cigarettes came to market in China back in 2004. By 2008, they had broken into most international markets. In that time, they were toted largely as quitting aids and misleadingly as harmless nicotine delivery devices (it would ultimately be determined that they do cause some harm but far less than conventional cigarettes). It wasn’t until 2011 that the first serious study into their success as smoking cessation devices was tested.
The study was done at the University of Catania (Italy), headed by the director of its Institute for Internal Medicine and Clinical Immunology. Riccardo Polosa had previously focused on asthma and COPD and eventually found himself looking into nicotine addiction. Electronic cigarettes appeared to hit the positive aspects of harm reduction without affecting public health, so Polosa organized a 6-month pilot study to investigate the devices.
The study took a rather surprising approach. It went after individuals that declined smoking cessation assistance–looking for those that were unrepentant smokers least likely to reduce smoking or quit entirely simply because they wanted to. Individuals over the age of 60, suffering hypertension, major depression, asthma, or other major health concerns were weeded out. The result was 40 candidates that smoked an average of 25 cigarettes a day, had no plans to quit, and no major health issue forcing them to quit.
By the end of the 24 week process, 27 subjects remained. More than 80% had cut their smoking down to less than half or quit altogether. Assuming electronic cigarettes were in fact less harmful than conventional tobacco cigarettes, this meant harm reduction could work. This pilot study proved promising enough that further research into electronic cigarettes as smoking cessation devices is now being conducted.
Success! Even with a crowd totally unwilling to receive assistance with smoking cessation, electronic cigarettes proved they could be a very powerful tool.
The study began with 66 subjects. Fourteen subjects were found ineligible because they requested smoking cessation assistance. Another 12 were removed from the study for various health related reasons including hypertension, depression, asthma, a recent case of myocardial infarction, and 2 cases of moderate oldness.
All subjects were age 18-60 that had smoked at least 15 factory-made cigarettes a day for 10 years. They were not currently nor were they planning within the next 30 days to be attempting to quit smoking. Subjects also didn’t have a history of alcohol abuse, illicit drug use, or psychiatric conditions.
The subjects were given electronic cigarettes and instructed in their basic use. They then returned for follow ups at 4 weeks, 8 weeks, 12 weeks, and 24 weeks. Some subjects failed to follow up at each of the intervals and were removed from the study. At the 24th week follow-up, 27 subjects remained.
The final results were quite promising. Twenty-two subjects (81% of the 27) had reduced their smoking by 50% or more up to 100% (meaning they had quit entirely). Thirteen subjects of the 22 continued smoking, though 5 of them had cut down by 80% or more. Even among the remaining 5 cessation failures, smoking of tobacco cigarettes declined.
Nine subjects had quit smoking entirely. Six of them continued using electronic cigarettes while the other 3 weren’t even using e-cigs.
According to Polosa, the e-cigs used in this study did have some mechanical problems and were already somewhat outdated by newer electronic cigarette technology on the market. So these numbers look even more promising considering better products were already available.
Current smoking intervention methods slightly improve the chances of success for an individual that wants to quit. Polosa concludes that electronic cigarettes may create a larger intervention market for individuals that don’t intend on quitting and individuals that have quit but fear returning to the addiction.