Perceived efficacy of e-cigarettes versus nicotine replacement therapy among successful e-cigarette users: a qualitative approach

[Vocalek]

http://www.ascpjournal.org/content/pdf/1940-0640-8-5.pdf

Barbeau AM, Burda J, Siegel M. Perceived efficacy of e-cigarettes versus nicotine replacement therapy among successful e-cigarette users: a qualitative approach. Addiction Science & Clinical Practice 2013, 8:5.

Abstract


Background:

Nicotine is widely recognized as an addictive psychoactive drug. Since most smokers are bio-behaviorally addicted, quitting can be very difficult and is often accompanied by withdrawal symptoms. Research indicates that nicotine replacement therapy (NRT) can double quit rates. However, the success rate for quitting remains low. E-cigarettes (electronic cigarettes) are battery-powered nicotine delivery devices used to inhale doses of vaporized nicotine from a handheld device similar in shape to a cigarette without the harmful chemicals present in tobacco products. Anecdotal evidence strongly suggests that e-cigarettes may be effective in helping smokers quit and preventing relapse, but there have been few published qualitative studies, especially among successful e-cigarette users, to support this evidence.

Methods:

Qualitative design using focus groups (N = 11); 9 men and 2 women. Focus groups were conducted by posing open-ended questions relating to the use of e-cigarettes, comparison of effectiveness between NRTs and e-cigarettes, barriers to quitting, and reasons for choosing e-cigarettes over other methods.

Results:
Five themes emerged that describe users' perceptions of why e-cigarettes are efficacious in quitting smoking: 1) bio-behavioral feedback, 2) social benefits, 3) hobby elements, 4) personal identity, and 5) distinction between smoking cessation and nicotine cessation. Additionally, subjects reported their experiences with NRTs compared with e-cigarettes, citing negative side effects of NRTs and their ineffectiveness at preventing relapse.

Conclusion:
These findings suggest tobacco control practitioners must pay increased attention to the importance of the behavioral and social components of smoking addiction. By addressing these components in addition to nicotine dependence, e-cigarettes appear to help some tobacco smokers transition to a less harmful replacement tool, thereby maintaining cigarette abstinence.

Keywords:

Smoking, E-cigarettes, Addiction, Smoking cessation, Qualitative research, Focus group

Article descriptionhttp://www.randallwebber.com/addiction_science_news

Tobacco Quit Rate Higher Among Those Using E-Cigarettes than Among Those Using Other Nicotine Replacement Therapy Methods


Tobacco quit rates among smokers using nicotine replacement therapy (NRT: nicotine patches, gum or lozenges) have traditionally been very low. Some reports have estimated the relapse rate within six months of initial abstinenece to be as high as 93%. However, few studies have measured quit rates among those employing E-cigarettes* (electronic cigarettes) as an aid to maintaining abstinence.


Previous studies employing e-cigarettes have found six-month quit rates of 22.5%, with an additional 32.5% of subjects having reduced their tobacco use by at least 50%. In fact, among those who used e-cigarettes 20 times or more per day, the six-month quit rate has been reported to be as high as 70%.


Despite the apparent superiority of e-cigarettes over other forms of NRT in promoting tobacco abstinence, no explanation of why this may be so has been identified. In the present study, a focus group of e-cigarettes users was convened, and the participants asked what they felt were the advantages of using those devices. Their answers fell into five areas: 1) biobehavioral mechanisms (e.g., the hand-to-mouth ritual of using the device); 2) social benefits (communication with and support from other e-cigarettes users); 3) hobby elements (e-cigarettes come in a variety of strengths, blends and flavors); 4) personal identity (finding satisfaction in being a "vaper" that previously came from being a smoker), and 5) the ability to give up smoking without giving up nicotine.


In addition to these factors, e-cigarettes may provide another significiant advantage over other forms of NRT. The nicotine from e-cigarettes is delivered much more rapidly to the bloodstream than from patches, gum and lozenges. The resultingly rapid onset of nicotine effects provides a "rush' similar to that associated with smoked tobacco, and may be an important factor in the ability of e-cigarettes to reduce tobacco relapse rates.

On a personal note, I believe one of the biggest reasons that NRTs are ineffective at preventing relapse is because the directions (and presumably your doctor) tell you to stop using them after 12 weeks--which means that withdrawal emerges, which triggers relapse.

 

[WalkinRuin]

Since you have been involved in this longer than I do you think they perceive tobacco smoking and nicotine addiction as one and the same? If you are still taking nicotine then you are still a tobacco smoker? I'm also not sure who "they" are, maybe the medical industry, FDA, or whoever designs these studies.

-Ray

 

[Luisa]

Since you have been involved in this longer than I do you think they perceive tobacco smoking and nicotine addiction as one and the same? If you are still taking nicotine then you are still a tobacco smoker? I'm also not sure who "they" are, maybe the medical industry, FDA, or whoever designs these studies.

-Ray

PM Volkalek--she can answer this better than I.

 

[Talyon]

Since you have been involved in this longer than I do you think they perceive tobacco smoking and nicotine addiction as one and the same? If you are still taking nicotine then you are still a tobacco smoker? I'm also not sure who "they" are, maybe the medical industry, FDA, or whoever designs these studies.

-Ray

I don't know who THEY are but NO Vapeing is not the same as smoking, similar YES but NOT smoking.