News on August 28th, new research shows that e-cigarettes are more effective than nicotine replacement therapy (NRT) for people who want to quit smoking or reduce smoking but cannot use traditional treatment methods before.

A study published in Addiction evaluated the efficacy of e-cigarettes compared with NRT in smokers who have tried previous treatments including NRT. It is a follow-up study of an earlier study by many of the same researchers, which found that e-cigarettes are more effective than NRT in quitting smoking in people who have not tried any treatment before.

These findings add to the growing body of evidence that e-cigarettes can reduce or quit smoking, but show that it is particularly useful for people who do not get the results they want from NRT.

After six months, only 3% of NRT participants remained quitting, compared with 19.1% in the e-cigarette group.

Participants in this study have previously tried NRT, varenicline (a drug commonly sold under the trade name Chantix), or both, to quit or reduce smoking, but none was successful. They are divided into NRT group and e-cigarette group.

People in the NRT group can choose nicotine patches, chewing gum, nasal sprays, micro-labels, inhalers, and oral sprays; people in the e-cigarette group get e-cigarettes with their chosen flavor and nicotine strength.

Although previous studies have found that when both products are accompanied by a large amount of behavioral support, e-cigarettes are more effective than NRT in quitting smoking, follow-up studies have found that smoking cessation and reduction of smoking are the same-even if the behavioral support is limited.

After six months, only 3% of NRT participants remained quitting, compared with 19.1% in the e-cigarette group. Although only 6% of NRT users reduced their smoking by at least 50%, the number of participants who used e-cigarettes was 26.5%.

"Many dependent smokers tried and tested many products, but couldn't stop it. Healthcare professionals and smoking cessation consultants should encourage the use of e-cigarettes." Lead author Dr. Katie Myers Smith said. "Even if they continue to use it for a long time, compared with continuing to smoke, it will be greatly reduced."

Allowing e-cigarette participants to choose their preferred intensity and taste may be critical to their success rate. Patient choice and autonomy are the backbone of harm reduction-it is an evidence-based approach to finding the treatment options that are most likely to benefit those trying to stop or reduce drug use. Harm reduction practices do not force people into certain treatment pathways, especially because we know that mandatory treatment greatly reduces the chances of success.

"Anyone who wants to quit smoking should consider using e-cigarettes."

When proposing options designed to reduce harm, habits and ritual aspects must be considered. E-cigarettes involve inhalation and hand-to-mouth exercise, which are closer to the NRT of combustible cigarettes, and help people maintain their social functions of nicotine use.

"E-cigarettes provide smokers with a device that can be customized according to the level of nicotine they get from smoking, but without toxins." Miles Smith said. "Due to the limited delivery of nicotine and the satisfaction and enjoyment they get from the product, NRT is often underutilized."

Some people who use e-cigarettes to quit combustibles use them as short-term assistance, with the goal of quitting e-cigarettes later. Others are using them as continuous substitutes. Long-term use of e-cigarettes needs to be viewed in the context of smokers who are difficult to reach, otherwise they will face higher health risks due to continued smoking.

According to this study, approximately 80% of smokers who had previously received treatment in clinical trials and received intensive treatment in routine care continued to smoke after one year. If a smoker cannot quit smoking through the best treatments currently available, and the provider wants the best results, why not provide a proven method that can reduce the harms of smoking without quitting nicotine?

"E-cigarettes are only a small part of the risk of continuing to smoke." Miles Smith said. "Anyone who wants to quit smoking should consider using e-cigarettes."

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