We’ve reached a tipping point in the debate over nicotine vaping. Scientists can no longer deny that e-cigarettes are powerful quit-smoking tools, and it’s time for doctors to recommend vaping to patients who can’t quit combustible tobacco.
I’ve defended both of those conclusions repeatedly in this column. But in this case, the arguments above aren’t mine, they’re Dr. Nancy Rigotti’s. In mid-February, the Harvard Medical School professor published an opinion piece in the prestigious New England Journal of Medicine (NEJM) titled Electronic Cigarettes for Smoking Cessation — Have We Reached a Tipping Point? Her answer is an unequivocal “yes.”
Rigotti’s op-ed appeared in the NEJM alongside the latest clinical trial to compare nicotine vaping and nicotine replacement therapy (NRT). The study split 1,246 participants into two groups, one using a refillable vaping device with e-liquid in their choice of nicotine strength and flavor and receiving smoking-cessation counseling. The other group received only smoking-cessation counseling, including NRT if they chose to use it.
After six months, 28.9 percent of smokers in the vaping group were smoke-free compared to just 16.3 percent in the counseling group. Those using vapor products also reported fewer respiratory symptoms at the half-year mark. Negative side effects “were few and similar in the two groups,” Rigotti noted.
In short, adding vaping to cessation counseling improved quit-smoking rates without exposing smokers to any serious health risks. It’s the same conclusion many studies have reached in recent years—including the latest meta-analysis published by the highly respected Cochrane Collaboration. Rigotti’s takeaway:
“The evidence now supports a strong conclusion that e-cigarettes are tools that clinicians can use to help adults stop smoking … It is now time for the medical community to acknowledge this progress and add e-cigarettes to the smoking-cessation toolkit.”
Many public health officials and activist groups in the US still refuse to acknowledge the quit-smoking potential of nicotine vaping. Instead, they faithfully repeat the FDA’s assertion that “more research is needed to understand the potential risks and benefits” of vaping to adult smokers.
Rigotti concluded her piece with a polite but pointed recommendation for these prohibitionist voices. If the goal is to reduce smoking and save lives, they need to abandon this rhetoric and fall in line behind the science. I’ll give her the last word:
“U.S. public health agencies and professional medical societies should reconsider their cautious positions on e-cigarettes for smoking cessation. The evidence has brought e-cigarettes to a tipping point. The burden of tobacco-related disease is too big for potential solutions such as e-cigarettes to be ignored.”
By Alli Boughner
