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*Citation: Jarvik ME. Beneficial effects of nicotine. Br J Addict. 1991 May;86(5):571-5. doi: 10.1111/j.1360-0443.1991.tb01810.x. PMID: 1859921.
*Citation: Jarvik ME. Beneficial effects of nicotine. Br J Addict. 1991 May;86(5):571-5. doi: 10.1111/j.1360-0443.1991.tb01810.x. PMID: 1859921.
*Acknowledgement: Supported by U. C. Tobacco-related Disease program, grant # RT87 and a grant from the John D. and Catherine T. MacArthur Foundation.
*Acknowledgement: Supported by U. C. Tobacco-related Disease program, grant # RT87 and a grant from the John D. and Catherine T. MacArthur Foundation.
==Smoking Cessation - Nicotine Replacement Therapy (NRT)==
==Smoking Cessation - E-cigarette (ENDS/ANDS) vs. NRT OR E-cigarette with NRT==
===2021: [https://harmreductionjournal.biomedcentral.com/articles/10.1186/s12954-021-00475-7 Electronic cigarettes in standard smoking cessation treatment by tobacco counselors in Flanders: E-cigarette users show similar if not higher quit rates as those using commonly recommended smoking cessation aids]===
*One third of the total sample was biochemically verified smoking abstinent 7 months after quit date, with e-cigarette users (40%) having significantly higher chances to be smoking abstinent than NRT users (23%).
*[https://harmreductionjournal.biomedcentral.com/track/pdf/10.1186/s12954-021-00475-7.pdf PDF Version]
*Citation: Adriaens, K., Belmans, E., Van Gucht, D. et al. Electronic cigarettes in standard smoking cessation treatment by tobacco counselors in Flanders: E-cigarette users show similar if not higher quit rates as those using commonly recommended smoking cessation aids. Harm Reduct J 18, 28 (2021). https://doi.org/10.1186/s12954-021-00475-7
*Acknowledgement: This research received no external funding. EB is supported by a PhD-fellowship of the Research Foundation – Flanders (FWO-Vlaanderen; 1177820N).
===2020: [https://pubmed.ncbi.nlm.nih.gov/32770246/ QuitNic: A pilot randomised controlled trial comparing nicotine vaping products with nicotine replacement therapy for smoking cessation following residential detoxification]===
*This pilot study showed that smoking cessation support involving options for nicotine replacement and Quitline-delivered cognitive behavioural counselling is attractive to people after they have been discharged from SUD (Substance Use Disorder) treatment.
*Retention was 63% at 6-weeks and 50% at 12-weeks. At 12-weeks, 68% of the NRT group reported using combination NRT while 96% of the NVP group used the device. Acceptability ratings for the products were high in both groups. At 12-weeks, 14% of the NVP group and 18% of the NRT group reported not smoking at all in the last 7 days. Mean CPD (Cigarettes Per Day) among continued smokers decreased significantly between baseline to 12-weeks in both groups; from 19.91 to 4.72 for the NVP group (p<0.001) and from 20.88 to 5.52 in the NRT group (p<0.001). Cravings and withdrawal symptoms significantly decreased for both groups.
*[https://sci-hub.se/10.1093/ntr/ntaa143 PDF Version]
===2020: [https://academic.oup.com/ntr/article/23/4/625/5906696?login=true Effectiveness of Electronic Cigarettes in Smoking Cessation: a Systematic Review and Meta-Analysis]===
*Our results suggest that nicotine-ECs may be more effective in smoking cessation when compared to placebo ECs or NRT.
*[https://sci-hub.st/10.1093/ntr/ntaa181 PDF Version]
===2019: [https://www.journalslibrary.nihr.ac.uk/hta/hta23430#/abstract E-cigarettes compared with nicotine replacement therapy within the UK Stop Smoking Services: the TEC RCT]===
*The primary outcome was CO-validated sustained abstinence rates at 52 weeks. Participants lost to follow-up or not providing biochemical validation were included as non-abstainers.
*The 1-year quit rate was 9.9% in the NRT arm and 18.0% in the e-cigarette arm.
*The e-cigarette arm had significantly higher validated quit rates at all time points. Participants in the e-cigarette arm showed significantly better adherence and experienced fewer urges to smoke throughout the initial 4 weeks of their quit attempt than those in the NRT arm, and gave their allocated product more favourable ratings. They were also more likely to be still using their allocated product at 1 year
*Participants assigned to e-cigarettes reported significantly less coughing and phlegm at 1 year than those assigned to NRT
*A detailed economic analysis confirmed that, because e-cigarettes incur lower NHS costs than NRT and generate a higher quit rate, e-cigarette use is more cost-effective.
*[https://njl-admin.nihr.ac.uk/document/download/2030301 PDF Version]
===2019: [https://onlinelibrary.wiley.com/doi/full/10.1111/add.14829 Cost‐effectiveness of e‐cigarettes compared with nicotine replacement therapy in stop smoking services in England (TEC study): a randomized controlled trial]===
*Using e‐cigarettes as a smoking cessation aid with standard behavioural support in stop‐smoking services in England is likely to be more cost‐effective than using nicotine replacement therapy in the same setting.
*[https://onlinelibrary.wiley.com/doi/epdf/10.1111/add.14829 PDF Version]
===2019: [https://pubmed.ncbi.nlm.nih.gov/31300577/ Effect of Electronic Cigarettes on Smoking Reduction and Cessation in Korean Male Smokers: A Randomized Controlled Study]===
* In our study, the effect of e-cigarettes on smoking cessation was similar compared with that of nicotine gum, a well-documented NRT. In addition, e-cigarettes were well tolerated by the study population. Therefore, the use of e-cigarettes as an NRT may be considered for smoking-cessation purposes.
*[https://sci-hub.se/10.3122/jabfm.2019.04.180384 PDF Version]
===2019: [https://www.nejm.org/doi/10.1056/NEJMoa1808779?fbclid=IwAR1598EmpCMPL9ORj38EoajDAdP1DfHk3spcWXvCa9UZPRI442YPvozZeWw A Randomized Trial of E-Cigarettes versus Nicotine-Replacement Therapy]===
*A total of 886 participants underwent randomization. The 1-year abstinence rate was 18.0% in the e-cigarette group, as compared with 9.9% in the nicotine-replacement group (relative risk, 1.83; 95% confidence interval [CI], 1.30 to 2.58; P<0.001). Among participants with 1-year abstinence, those in the e-cigarette group were more likely than those in the nicotine-replacement group to use their assigned product at 52 weeks (80% [63 of 79 participants] vs. 9% [4 of 44 participants]). Overall, throat or mouth irritation was reported more frequently in the e-cigarette group (65.3%, vs. 51.2% in the nicotine-replacement group) and nausea more frequently in the nicotine-replacement group (37.9%, vs. 31.3% in the e-cigarette group). The e-cigarette group reported greater declines in the incidence of cough and phlegm production from baseline to 52 weeks than did the nicotine-replacement group (relative risk for cough, 0.8; 95% CI, 0.6 to 0.9; relative risk for phlegm, 0.7; 95% CI, 0.6 to 0.9). There were no significant between-group differences in the incidence of wheezing or shortness of breath.
*Conclusion: E-cigarettes were more effective for smoking cessation than nicotine-replacement therapy, when both products were accompanied by behavioral support.
*[https://www.nejm.org/doi/pdf/10.1056/NEJMoa1808779 PDF Version]
===2019: [https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(19)30269-3/fulltext Nicotine patches used in combination with e-cigarettes (with and without nicotine) for smoking cessation: a pragmatic, randomised trial]===
*In summary, when looking at continuous abstinence from smoking, provision of patches plus a nicotine e-cigarette resulted in three to seven more smokers per 100 quitting long-term (depending on the analyses done) than with patches plus a nicotine-free e-cigarette. The smaller than anticipated sample size meant the study was not sensitive enough to pick up a definitive finding for the second comparison, although analyses suggest combination nicotine therapy—ie, use of a slow release nicotine patch, together with a faster-acting oral nicotine product (in this case a nicotine e-cigarette)—could result in five to ten more smokers per 100 quitting long-term than with monotherapy (ie, nicotine patches alone). Our findings are consistent with the current findings of the Cochrane review of e-cigarettes for smoking cessation and contribute to the growing body of evidence from randomised trials on the efficacy, effectiveness and safety of e-cigarettes for smoking cessation.
*[https://www.nejm.org/doi/pdf/10.1056/NEJMoa1808779 PDF Version]
===2018: [https://www.casaa.org/wp-content/uploads/American-Cancer-Society-Position-Statement-on-Electronic-Cigarettes.pdf American Cancer Society Position Statement on Electronic Cigarettes]===
*Based on currently available evidence, using current generation e-cigarettes is less harmful than smoking cigarettes, but the health effects of long-term use are not known.
*The ACS has always supported any smoker who is considering quitting, no matter what approach they use; there is nothing more important that they can do for their health.
Some smokers, despite firm clinician advice, will not attempt to quit smoking cigarettes and will not use FDA approved cessation medications.  These individuals should be encouraged to switch to the least harmful form of tobacco product possible; switching to the exclusive use of e-cigarettes is preferable to continuing to smoke combustible products.
===2018: [https://onlinelibrary.wiley.com/doi/10.1111/add.14527 Discussions between health professionals and smokers about nicotine vaping products: results from the 2016 ITC Four Country Smoking and Vaping Survey]===
*Despite the need for more evidence on their efficacy and long‐term safety, NVPs are now a more popular method for cessation than licensed NRT and prescription stop‐smoking medications in many countries.
*In light of this, HPs should be prepared to provide balanced information about NVPs, particularly to smokers who are unable to stop smoking with approved cessation therapies, and for those who are requesting guidance regarding NVPs as a smoking cessation aid
*Overall, the results from this study have shown that discussions between smokers and HPs about both quitting smoking, and the possible role NVPs could play as a cessation aid, were infrequent in the four countries in 2016. This may represent a lost opportunity for encouraging quitting smoking by providing a potentially attractive option to help smokers to quit.
*[https://onlinelibrary.wiley.com/doi/epdf/10.1111/add.14527 PDF Version]
===2016: E-cigarettes: a developing public health consensus===
*From: Public Health England, Action on Smoking and Health, Association of Directors of Public Health, British Lung Foundation, Cancer Research UK, Faculty of Public Health, Fresh North East, Healthier Futures, Public Health Action, Royal College of Physicians, Royal Society for Public Health, UK Centre for Tobacco and Alcohol Studies, UK Health Forum
*We all agree that e-cigarettes are significantly less harmful than smoking. One in two lifelong smokers dies from their addiction. All the evidence suggests that the health risks posed by e-cigarettes are relatively small by comparison but we must continue to study the long-term effects.
*And yet, millions of smokers have the impression that e-cigarettes are at least as harmful as tobacco
*The public health opportunity is in helping smokers to quit, so we may encourage smokers to try vaping but we certainly encourage vapers to stop smoking tobacco completely.
*We know that e-cigarettes are the most popular quitting tool in the country with more than 10 times as many people using them than using local stop smoking services
*The current national evidence is that in the UK regular e-cigarette among youth use is almost exclusively confined to those young people who have already smoked, and youth smoking prevalence is continuing to fall
We should not forget what is important here. We know that smoking is the number one killer in England and we have a public health responsibility to provide smokers with the information and the tools to help them quit smoking completely and forever.
===2014: Real-world effectiveness of e-cigarettes when used to aid smoking cessation: a cross-sectional population study===
Conclusion: “Among smokers who have attempted to stop without professional support, those who use e-cigarettes are more likely to report continued abstinence than those who used a licensed NRT product bought over-the-counter or no aid to cessation. This difference persists after adjusting for a range of smoker characteristics such as nicotine dependence.”
===2014: E-cigarette versus nicotine inhaler: comparing the perceptions and experiences of inhaled nicotine devices=== 
Related Article: E-Cigarettes vs. Nicotine Inhalers
“In conclusion, during this brief trial, the e-cigarette was found to be more acceptable, provided more satisfaction and rewards, and had higher perceived benefit than the nicotine inhaler. These findings may explain why the e-cigarette has become popular among smokers while the inhaler has not achieved the same favorability. Based on this difference, e-cigarettes could have the potential to become “tobacco cigarette substitutes,” owing to their high acceptance and perceived effectiveness. While toxicants have been identified in e-cigarettes, they are present at orders of magnitude lower than tobacco cigarettes. As such, e-cigarettes may hold value as a harm reduction strategy among those unwilling or unable to quit. However, given the large variation in the market with respect to brands, more data are needed to demonstrate their efficacy and safety, and to allow physicians to more appropriately inform their patients about these products.”
===2013: Electronic cigarettes for smoking cessation: a randomised controlled trial===
657 people were randomised (289 to nicotine e-cigarettes, 295 to patches, and 73 to placebo e-cigarettes) and were included in the intention-to-treat analysis.
At 6 months, verified abstinence was 7·3% (21 of 289) with nicotine e-cigarettes, 5·8% (17 of 295) with patches, and 4·1% (three of 73) with placebo e-cigarettes
===2013: A fresh look at tobacco harm reduction: the case for the electronic cigarette===
Smokers of any age can reap substantial health benefits by quitting. In fact, no other single public health effort is likely to achieve a benefit comparable to large-scale smoking cessation.
E-cigs might be the most promising product for tobacco harm reduction to date, because, besides delivering nicotine vapour without the combustion products that are responsible for nearly all of smoking’s damaging effect, they also replace some of the rituals associated with smoking behaviour.
Nicotine’s beneficial effects include correcting problems with concentration, attention and memory, as well as improving symptoms of mood impairments. Keeping such disabilities at bay right now can be much stronger motivation to continue using nicotine than any threats of diseases that may strike years and years in the future.
Nicotine’s beneficial effects can be controlled, and the detrimental effects of the smoky delivery system can be attenuated, by providing the drug via less hazardous delivery systems. Although more research is needed, e-cigs appear to be effective cigarette substitutes for inveterate smokers, and the health improvements enjoyed by switchers do not differ from those enjoyed by tobacco/nicotine abstainers.
===2013: Electronic cigarettes and vaping: a new challenge in clinical medicine and public health. A literature review===
When compared to the harmful effects of smoking, these studies suggest that vaping could be used as a possible “harm reduction” tool. There is evidence supporting e-cigarettes as an aide for smoking cessation, at least as successful as currently available FDA-approved NRTs.
===2011: Successful smoking cessation with electronic cigarettes in smokers with a documented history of recurring relapses: a case series===
The most important message from this case series is that these smokers, with a documented history of recurring relapses, were able to quit smoking and to remain abstinent for at least six months after taking up an electronic cigarette.
==Smoking Cessation / Preventing Relapse - E-cigarette (ENDS/ANDS) - Stand Alone==
===2020: Highlights of Studies in Cardiovascular Disease Prevention Presented at the 2020 American College of Cardiology Annual Scientific Session===
In E3, nicotine e-cigarettes plus counseling was superior to counseling alone for smoking cessation. Non-nicotine e-cigarettes plus counseling was also more effective compared with counseling alone though its effects on cessation were modest. This trial demonstrates the efficacy of e-cigarettes as a tool for smoking cessation compared with counseling alone.
===2020: A magic bullet? The potential impact of e-cigarettes on the toll of cigarette smoking===
The combination of assumptions produces 360 possible scenarios. 357 (99%) yield positive estimates of life-years saved (LYS) due to vaping by 2100, from 143,000 to 65 million.
The impact of vaping is greatest when it most helps smokers who otherwise have the greatest difficulty quitting smoking.
Vaping is highly likely to reduce smoking-produced mortality. Still, vaping is not “the” answer to the public health crisis created by smoking. Rather, it may well be a tool to add to the armamentarium of effective tobacco control measures.
Harm reduction can, and many would say should, be a part of the complex formula that will eventually bring about the demise of smoking.
===2020: [https://academic.oup.com/ntr/advance-article-abstract/doi/10.1093/ntr/ntaa182/5906689?redirectedFrom=fulltext Patterns of e-cigarette use and subsequent cigarette smoking cessation over two years (2013/2014 to 2015/2016) in the Population Assessment of Tobacco and Health (PATH) Study]===
*Smoking cessation was more likely among frequent e-cigarette users, users of e-cigarettes in last quit attempt, and users of flavored and rechargeable devices.
*In this study, the proportion of US adults who incorrectly perceived e-cigarettes as equal to, or more, harmful than cigarettes increased steadily regardless of smoking or vaping status. Current adult smokers appear to be poorly informed about the relative risks of e-cigarettes yet have potentially the most to gain from transitioning to these products. The findings of this study emphasise the urgent need to accurately communicate the reduced relative risk of e-cigarettes compared to continued cigarette smoking and clearly differentiate absolute and relative harms.
*The lack of accurate and consistent messaging from both public health agencies and the media may be contributing to public, and more specifically adult smokers’, perceptions about the relative risk of nicotine when decoupled from combustion and tobacco smoke.
*Confusion may potentially be discouraging adult smokers from using alternative, less hazardous products which may ultimately result in a missed opportunity to positively impact health at both an individual and population level.
*[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7501702/pdf/12954_2020_Article_410.pdf PDF Version]
*Citation: Allison M Glasser, MPH, Mahathi Vojjala, MPH, Jennifer Cantrell, DrPH, MPA, David T Levy, PhD, Daniel P Giovenco, PhD, MPH, David Abrams, PhD, Raymond Niaura, PhD, Patterns of E-cigarette Use and Subsequent Cigarette Smoking Cessation Over 2 Years (2013/2014–2015/2016) in the Population Assessment of Tobacco and Health Study, Nicotine & Tobacco Research, , ntaa182, doi: 10.1093/ntr/ntaa182
*Acknowledgement: The paper was funded by Imperial Brands Plc.
===2020: Using e-cigarettes for smoking cessation: evaluation of a pilot project in the North West of England===
Of the 1022 participants who engaged with the pilot 614 were still engaged at 4 weeks, of whom 62% had quit smoking. Of those who still smoked tobacco at week 4, smoking had reduced from a baseline of 19.1 cigarettes/day to 8.7. Overall, 37% of those initially enrolled were confirmed to be using an e-cigarette on its own at follow-up. Successful quit was associated with occupation (unemployed, 33% vs intermediate, 47%) and residing in the less deprived quintiles of deprivation (50% vs 34% in the most deprived quintile.
E-cigarettes appear to be an effective nicotine replacement therapy
===2020: Tobacco harm reduction in the 21st century===
In conclusion, to reduce smoking and to save millions of lives, tobacco harm reduction in the form of cigarette substitution with low-risk products appears to be a promising path. These products, although not completely risk-free, offer an alternative to quit or die. In consideration of the available evidence, advice to tobacco smokers should include trying substitute products. The obvious fact so often overlooked is that smoking is rewarding and people like to do it. Giving smokers an alternative with efficient nicotine delivery means that they might prefer one of these products over cigarettes.
===2019: Association Between Electronic Cigarette Use and Smoking Reduction in France===
Findings  This cohort study found that, among daily smokers in France, regular (daily) electronic cigarette use is associated with a significantly higher decrease in the number of cigarettes smoked per day as well as an increase in smoking cessation attempts. However, among former smokers, electronic cigarette use is associated with an increase in the rate of smoking relapse.
NOTE: Article that covers above study - Adults who vape are more likely to quit cigarettes, study finds
“The study did find that the heightened risk of relapse disappeared in those who quit smoking more recently, which the researchers said may be due to improved e-cigarette technology.”
“For example, the study as a whole considered anybody who quit smoking from 2010 onward and found that, in that sample, vaping increased the risk of relapse. But when researchers only considered people who quit cigarettes as of 2013, former smokers were not more likely to relapse if they vaped.”
“The researchers noted in their study that "measures of plasma nicotine levels have shown that, compared with older models of [e-cigarettes], the new generation delivers higher levels of nicotine to the bloodstream," which may make them more satisfying.”
“Other "technical improvements in [e-cigarettes] over time," they said, may also explain why people who recently quit smoking and switched to e-cigarettes were less likely to relapse than those who quit earlier.”
===2019: Association of prevalence of electronic cigarette use with smoking cessation and cigarette consumption in England: a time–series analysis between 2007 and 2017===
The increase in prevalence of e‐cigarette use by smokers in England has been positively associated with an increase in success rates of quit attempts and overall quit rates
===2019 Electronic Cigarette Use and Cigarette Abstinence Over 2 Years Among U.S. Smokers in the Population Assessment of Tobacco and Health Study===
In this nationally representative longitudinal cohort study of US adult cigarette smokers, daily e-cigarette use, compared to no e-cigarette use, was associated with a 77% increased odds of prolonged cigarette smoking abstinence over the subsequent 2 years. Regular use of e-cigarettes may help some smokers to stop smoking combustible cigarettes.
Article: Daily e-cigarette use may help smokers quit regular cigarettes
===2019 Article: Adults who vape are more likely to quit cigarettes, study finds===
“The study did find that the heightened risk of relapse disappeared in those who quit smoking more recently, which the researchers said may be due to improved e-cigarette technology.”
“For example, the study as a whole considered anybody who quit smoking from 2010 onward and found that, in that sample, vaping increased the risk of relapse. But when researchers only considered people who quit cigarettes as of 2013, former smokers were not more likely to relapse if they vaped.”
“The researchers noted in their study that "measures of plasma nicotine levels have shown that, compared with older models of [e-cigarettes], the new generation delivers higher levels of nicotine to the bloodstream," which may make them more satisfying.”
“Other "technical improvements in [e-cigarettes] over time," they said, may also explain why people who recently quit smoking and switched to e-cigarettes were less likely to relapse than those who quit earlier.”
===2018 [https://academic.oup.com/ntr/article-abstract/20/8/977/4061315?redirectedFrom=fulltext Advice From Former-Smoking E-Cigarette Users to Current Smokers on How to Use E-Cigarettes as Part of an Attempt to Quit Smoking]===
*This study describes the advice that former-smokers who used e-cigarettes to quit smoking would offer to smokers who are considering using an e-cigarette to support an attempt to quit smoking. Vapers advised smokers to find the right combination of device, flavors and nicotine strength, continue to smoke and vape for a while if they wished, not be deterred by past failed attempts to quit smoking, and expect health to improve after they have switched to vaping. Encouraging smokers to interact with vaping peers in vape shops and in online vaping-dedicated discussion forums may help significantly more smokers switch to vaping.
*[https://sci-hub.do/10.1093/ntr/ntx176# PDF Version]
*Citation: Christopher Russell, PhD, Tiffany Dickson, MSc, Neil McKeganey, PhD, Advice From Former-Smoking E-Cigarette Users to Current Smokers on How to Use E-Cigarettes as Part of an Attempt to Quit Smoking, Nicotine & Tobacco Research, Volume 20, Issue 8, August 2018, Pages 977–984, doi: 10.1093/ntr/ntx176
*Acknowledgement: Funding for this study was provided by Nicoventures.
===2017: Predicting Short-Term Uptake of Electronic Cigarettes: Effects of Nicotine, Subjective Effects, and Simulated Demand===
Mean cigarettes per day decreased by 37% when e-cigarettes were available relative to baseline. Nicotine-containing cartridges were associated with greater use and craving reduction than 0 mg. Alleviation of withdrawal symptoms and taste and enjoyment factors predicted e-cigarette use.
===2017: Cohort study of electronic cigarette use: effectiveness and safety at 24 months===
Of the e-cigarette users, 61.1% remained abstinent from tobacco (while 23.1% and 26.0% of tobacco-only smokers and dual users achieved tobacco abstinence).
===2016: Patterns of Electronic Cigarette Use Among Adults in the United States===
Results: Current e-cigarette use is extremely low among never cigarette smokers (0.4%) and former smokers who quit cigarettes 4 or more years ago (0.8%). Although e-cigarette experimentation is most common among current cigarette smokers and young adults, daily use is highest among former smokers who quit in the past year (13.0%) and older adults. Compared to daily cigarette smokers, recently quit smokers were more than four times as likely to be daily users of e-cigarettes ( AOR : 4.33 [95% CI: 3.08–6.09]).
Conclusion: Extremely low e-cigarette use among never-smokers and longer term former smokers suggest that e-cigarettes neither promote widespread initiation nor relapse among adults. Recognition of the heterogeneity of smokers, including the time since quitting, is critical to draw accurate conclusions about patterns of e-cigarette use at the population level and its potential for public health benefit or harm.
===2016: Electronic cigarette use in the European Union: analysis of a representative sample of 27 460 Europeans from 28 countries===
E‐cigarette use in the European Union appears to be largely confined to current or former smokers, while current use and nicotine use by people who have never smoked is rare. More than one‐third of current e‐cigarette users polled reported smoking cessation and reduction.
===2015: E-Cigarettes and Smoking Cessation: Evidence from a Systematic Review and Meta-Analysis===
Conclusions: “This systematic review and meta-analyses assessed the findings of six studies which reported smoking cessation after using e-cigarettes. We found an association between nicotine-enriched e-cigarette use and smoking cessation, suggesting that the devices may be an effective alternative smoking cessation method. We also found that use of e-cigarettes was also associated with a reduction in the number of cigarettes used, suggesting they may also have a role in tobacco harm reduction programs. To our knowledge, this is the most comprehensive evidence to date on this issue, and while there are a number of important implications for further research, these findings provide timely information to inform regulatory strategies.”
===2015: A Longitudinal Study of Electronic Cigarette Use Among a Population-Based Sample of Adult Smokers: Association With Smoking Cessation and Motivation to Quit===
Results: At follow-up, 23% were intensive users, 29% intermittent users, 18% had used once or twice, and 30% had not tried e-cigarettes. Logistic regression controlling for demographics and tobacco dependence indicated that intensive users of e-cigarettes were 6 times more likely than non-users/triers to report that they quit smoking (OR: 6.07, 95% CI = 1.11, 33.2). No such relationship was seen for intermittent users. There was a negative association between intermittent e-cigarette use and 1 of 2 indicators of motivation to quit at follow-up.
Conclusion: Daily use of electronic cigarettes for at least 1 month is strongly associated with quitting smoking at follow-up. Further investigation of the underlying reasons for intensive versus intermittent use will help shed light on the mechanisms underlying the associations between e-cigarette use, motivation to quit, and smoking cessation.
===2015: Associations Between E-Cigarette Type, Frequency of Use, and Quitting Smoking: Findings From a Longitudinal Online Panel Survey in Great Britain===
Conclusion: Whether e-cigarette use is associated with quitting depends on type and frequency of use. Compared with respondents not using e-cigarettes, daily tank users were more likely, and non-daily cigalike users were less likely, to have quit. Tanks were more likely to be used by older respondents and respondents with lower education.
===2015: Electronic Cigarettes Efficacy and Safety at 12 Months: Cohort Study (PDF 14 pages)===
Results: Follow-up data were available for 236 e-smokers, 491 tobacco smokers, and 232 dual smokers (overall response rate 70.8%). All e-smokers were tobacco ex-smokers. At 12 months, 61.9% of the e-smokers were still abstinent from tobacco smoking; 20.6% of the tobacco smokers and 22.0% of the dual smokers achieved tobacco abstinence. Adjusting for potential confounders, tobacco smoking abstinence or cessation remained significantly more likely among e-smokers...
===2014: Effectiveness of the Electronic Cigarette: An Eight-Week Flemish Study with Six-Month Follow-up on Smoking Reduction, Craving and Experienced Benefits and Complaints===
When people, ready to switch to an e-cig, are severely restricted in terms of accessibility of nicotine-containing e-liquids, the success of e-cigs may be endangered. For the e-cig to be and remain successful, it is important that people have easy access to nicotine containing e-liquids.
Conclusion: “In a series of controlled lab sessions with e-cig-naïve tobacco smokers, second-generation e-cigs were shown to be immediately and highly effective in reducing abstinence-induced cigarette craving and withdrawal symptoms, while not resulting in increases in eCO. Ad libitum use of e-cigs—in between and until six months after the lab sessions—resulted in remarkable reductions in or (biologically confirmed) complete abstinence from tobacco smoking in almost half of the participants who had no intention to quit smoking. [highlighting added] Eight months after the start of the study 21% of all participants were completely abstinent from tobacco cigarettes. Similar reduction/cessation rates were obtained with guided versus non-guided switching to e-cigs. Part of the observed efficacy of e-cigs in this study may be related to the fact that they allowed to maintain relatively high blood nicotine levels and showed an excellent experienced benefits/complaints ratio, especially in comparison with continued tobacco smoking”...
E-cigarette is an attractive long-term alternative and safer source of nicotine to conventional cigarette. Since their invention in 2003, there has been constant innovation and development of more efficient and appealing products. Here we show for the first time that second generation PVs can substantially decrease cigarette consumption without causing significant side effects in smokers not intending to quit. Moreover, overall participants’ perception and acceptance of these products was very good, in particular for those who quit or reduced smoking. Compared to our earlier work with first generation “cig-alikes”, technical problems and difficulties in use familiarization with second generation PVs were negligible. Improved products reliability and attractiveness might have contributed to the very low number of study failures and lost to follow-up and high success rates thus confirming the notion that these products are attractive substitutes for conventional cigarettes. Although large and carefully conducted RCTs will be required to confirm these preliminary encouraging observations, the notion that second generation PVs can substantially decrease cigarette consumption in smokers not intending to quit should be taken into consideration by regulatory authorities seeking to adopt proportional measures for the vapour category
===2014: Success rates with nicotine personal vaporizers: a prospective 6-month pilot study of smokers not intending to quit===
Complete tobacco cessation is the best outcome for smokers, but the powerful addictive qualities of nicotine and of the ritualistic behavior of smoking create a huge hurdle, even for those with a strong desire to quit. Tobacco harm reduction (THR), the substitution of low-risk nicotine products for cigarette smoking, is a realistic strategy for smokers who have difficulty quitting. E-cigarettes are the newest and most promising products for THR. This approach has been recently exploited to reduce or reverse the burden of harm in smokers with mental health disorders and chronic airway disease.
===2014: Characteristics, Perceived Side Effects and Benefits of Electronic Cigarette Use: A Worldwide Survey of More than 19,000 Consumers===
The main results of this survey indicate that ECs may be an effective substitute for smoking even in highly dependent subjects who are heavy smokers. Significant benefits are experienced by these people in physiologic functions and in some disease conditions, with former smokers (those who completely substituted smoking with EC use) being more likely to report such beneficial effects.
Both former and current smokers initiated EC use with high nicotine-containing liquids. More than one-fifth of the population initiated use with more than 20 mg/mL nicotine concentration, with higher prevalence in former smokers, supporting the hypothesis that nicotine plays an important role in the success of ECs as smoking substitutes [4,16]. This can be attributed to the lower nicotine absorption from EC use compared to smoking [13,17,18]. Such repeated observations should be taken into consideration by the regulatory authorities.
The most important reasons for participants to initiate ECs were to reduce or completely quit smoking and to reduce exposure of family members to second-hand smoking. It seems that these subjects are well-informed about the adverse health effects of smoking and are willing to try an alternative product which they consider less harmful.
In conclusion, in this large sample of dedicated EC users, it seems that ECs are used as long-term substitutes to smoking. They can be effective even in subjects who are highly dependent on smoking and are heavy smokers. Mild temporary side-effects and significant benefits are reported by this population. Motivation for using ECs comes from their expected less harmful potential compared to smoking.
===2014: Reasons for quitting cigarette smoking and electronic cigarette use for cessation help===
Thus, this may be the first study to suggest that smokers who want to quit smoking for immediate, extrinsic rewards may be attracted to use e-cigarettes to stop smoking cigarettes than smokers who want to quit smoking for intrinsic reasons such as health concerns. In conclusion, e-cigarettes appear to provide a “smoking” alternative to a section of cigarette smokers who may not quit smoking for health reasons. Public health efforts may need to consider employing e-cigarettes to promote tobacco-related harm reduction.
===2014: Cigarette Users’ Interest in Using or Switching to Electronic Nicotine Delivery Systems (ENDS) for Smokeless Tobacco for Harm Reduction, Cessation, or Novelty: A Cross-Sectional Survey of US Adults===
This study highlights higher interest in ENDS versus smokeless tobacco and greater interest in both for harm reduction and cessation than due to novelty or smoking restrictions.
27.2% of current smokers had talked with a health care provider about ENDS, with 18.0% reporting that their provider endorsed ENDS use for cessation.
Developing educational campaigns and informing practitioners about ENDS as cessation or harm reduction aids is critical.
===2013: E-Cigarettes: Prevalence and Attitudes in Great Britain===
While we found evidence supporting the view that e-cigarette use may be a bridge to quitting, we found very little evidence of e-cigarette use among adults who had never smoked. British smokers would benefit from information about the effective use, risks, and benefits of e-cigarettes, as this might enable the use of e-cigarettes to improve public health.
===2013: EffiCiency and Safety of an eLectronic cigAreTte (ECLAT) as Tobacco Cigarettes Substitute: A Prospective 12-Month Randomized Control Design Study===
Conclusion: “In smokers not intending to quit, the use of e-cigarettes, with or without nicotine, decreased cigarette consumption and elicited enduring tobacco abstinence without causing significant side effects.”
===2013: 'Vaping' profiles and preferences: an online survey of electronic cigarette users===
Seventy-four percent of participants reported not smoking for at least a few weeks since using the e-cigarette and 70% reported reduced urge to smoke. Seventy-two percent of participants used a 'tank' system, most commonly. Mean duration of use was 10 months. Only 1% reported exclusive use of non-nicotine containing liquid. E-cigarettes were generally considered to be satisfying to use; elicit few side effects; be healthier than smoking; improve cough/breathing; and be associated with low levels of craving. Among ex-smokers, 'time to first vape' was significantly longer than 'time to first cigarette' suggesting a lower level of dependence to e-cigarettes. Ex-smokers reported significantly greater reduction in craving than current smokers.
E-cigarettes are used primarily for smoking cessation, but for a longer duration than nicotine replacement therapy, and users believe them to be safer than smoking
===2012: The electronic-cigarette: Effects on desire to smoke, withdrawal symptoms and cognition===
The e-cigarette can reduce desire to smoke and nicotine withdrawal symptoms 20 minutes after use.
The nicotine content in this respect may be more important for males.
The first study to demonstrate that the nicotine e-cigarette can improve working memory.
===2011: Effect of an electronic nicotine delivery device (e-Cigarette) on smoking reduction and cessation: a prospective 6-month pilot study===
Sustained 50% reduction in the number of cig/day at week-24 was shown in 13/40(32.5%) participants; their median of 25 cigs/day decreasing to 6 cigs/day (p < 0.001). Sustained 80% reduction was shown in 5/40(12.5%) participants; their median of 30 cigs/day decreasing to 3 cigs/day (p = 0.043). Sustained smoking abstinence at week-24 was observed in 9/40(22.5%) participants, with 6/9 still using the e-Cigarette by the end of the study. Combined sustained 50% reduction and smoking abstinence was shown in 22/40 (55%) participants, with an overall 88% fall in cigs/day.
The use of e-Cigarette substantially decreased cigarette consumption without causing significant side effects in smokers not intending to quit
===2011: Electronic cigarette: users profile, utilization, satisfaction and perceived efficacy===
Almost all (97%) used e‐cigarettes containing nicotine.
Most (96%) said the e‐cigarette helped them to quit smoking or reduce their smoking (92%).
Reasons for using the e‐cigarette included the perception that it was less toxic than tobacco (84%), to deal with craving for tobacco (79%) and withdrawal symptoms (67%), to quit smoking or avoid relapsing (77%), because it was cheaper than smoking (57%) and to deal with situations where smoking was prohibited (39%).
Most ex‐smokers (79%) feared they might relapse to smoking if they stopped using the e‐cigarette.
Users of nicotine‐containing e‐cigarettes reported better relief of withdrawal and a greater effect on smoking cessation than those using non‐nicotine e‐cigarettes.
===2011: Electronic cigarettes (e‐cigs): views of aficionados and clinical/public health Perspectives===
The health risks from smoking are large and are known with certainty. Comparatively, the health risks from e‐cig use are likely much smaller (if any) and temporarily switching to e‐cigs will likely yield a large health benefit.
If the patient perceives that the e‐cig is helping them to stay off cigarettes and is not reporting any health problems likely attributable to the e‐cig, then the focus should be on staying smoke‐free rather than e‐cig free.
===2011: Electronic Cigarettes As a Smoking-Cessation Tool: Results from an Online Survey===
A large percentage of respondents reported a reduction in the number of cigarettes they smoked (66.8%) and almost half reported abstinence from smoking for a period of time (48.8%). Those respondents using e-cigarettes more than 20 times per day had a quit rate of 70.0%. Of respondents who were not smoking at 6 months, 34.3% were not using e-cigarettes or any nicotine-containing products at the time.
===2011: Interviews With “Vapers”: Implications for Future Research With Electronic Cigarettes===
Experienced users report health gains typical for smoking cessation despite continued vaping.
There were pervasive themes including the language and culture of vaping; social and informational support among vapers, motives and perceived benefits of using e-cigs versus cigarettes including cigarette-like enjoyment, cost, restored sense of taste and smell, and improved breathing and exercise tolerance; rapidly reduced nicotine tolerance and dependence; and a strong interest in e-cig–related research and policy.
===2010: Effect of an electronic nicotine delivery device (e cigarette) on desire to smoke and withdrawal, user preferences and nicotine delivery: randomised cross-over trial===
Conclusions “The 16 mg Ruyan V8 ENDD alleviated desire to smoke after overnight abstinence, was well tolerated and had a pharmacokinetic profile more like the Nicorette inhalator than a tobacco cigarette. Evaluation of the ENDD for longer-term safety, potential for long-term use and efficacy as a cessation aid is needed.”
===2010: Electronic cigarettes: a survey of users===
Our results suggest that ecigarettes are used mainly to quit smoking, and may be useful for this purpose.




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