GPs should consider advising smokers who are unable or unwilling to quit through other routes to switch to e-cigarettes as a safer alternative to smoking, suggests recent research.
The researchers reviewed 81 papers – identified by database searches – to research the content and safety of e-cigarettes.
They found that e-cigarette users and non-users had the same quit rate for smoking, but that e-cigarette use was associated with a significant reduction in cigarette consumption. Large population samples found that smokers were more likely to quit with the use of e-cigarettes, compared with those using nicotine replacement therapy (NRT) or trying to quit unaided.
A look at the contents of e-cigarettes showed that e-cigarette aerosol can contain some of the toxicants that are present in tobacco smoke, such as nitrosamines and diethylene glycol, but at levels which are much lower. For example, analysis identified low levels of formaldehyde and acetaldehyde. In some cases, these were comparable to levels found in NRT, and overall at levels nine and 450 times lower, respectively, than in cigarette smoke. Some users of e-cigarettes achieved nicotine levels close to those obtained from smoking – up to 14 ng/ml, compared with 10-20 ng/ml after smoking a cigarette – but only after 60 minutes of inconsistent use.
In two randomised trials, there were no significant differences in adverse events, such as mouth and throat irritation, between e-cigarette and control groups.
The researchers noted that ‘while there is not yet conclusive evidence about the effectiveness of e-cigarettes to generate smoking cessation or reduction, healthcare professionals should support smokers who wish to switch to e-cigarettes to reduce harm from smoking’.
