A Randomized Trial of E-Cigarettes versus Nicotine-Replacement Therapy.

Area of Science:

• Public Health
• Addiction Medicine
• Clinical Trials

Background:

• E-cigarettes are frequently used for smoking cessation attempts.
• Limited evidence exists comparing e-cigarette effectiveness against approved nicotine cessation treatments.

Purpose of the Study:

• To compare the effectiveness of e-cigarettes versus nicotine-replacement therapy (NRT) for smoking cessation.
• To evaluate sustained abstinence rates and secondary outcomes including treatment usage and respiratory symptoms.

Main Methods:

• Randomized controlled trial involving 886 adults in UK National Health Service stop-smoking services.
• Participants received either e-cigarettes or NRT, with weekly behavioral support for at least 4 weeks.
• Primary outcome was 1-year sustained smoking abstinence, validated biochemically.

Main Results:

• 1-year abstinence rate was 18.0% in the e-cigarette group versus 9.9% in the NRT group (RR 1.83, P<0.001).
• E-cigarette users were more likely to use their assigned product at 52 weeks.
• E-cigarette group showed greater reductions in cough and phlegm, but more throat/mouth irritation.

Conclusions:

• E-cigarettes are more effective for smoking cessation than NRT when both are accompanied by behavioral support.
• Findings support the use of e-cigarettes as a smoking cessation aid.