Using an electronic cigarette won’t make you any more likely to quit smoking actual cigarettes, according to a new study.

In a new research letter published March 24 in JAMA Internal Medicine, researchers at the University of California San Francisco surveyed the same group of about 950 smokers in November 2011 and 2012 and asked them about their smoking habits. They found those who tried e cigarettes were no more likely to quit than those who hadn’t.

For the baseline survey, participants were asked if they had used electronic cigarettes in the past 30 days (even once) how many conventional cigarettes they smoked per day time to first cigarette (less than or more than 30 minutes after waking each day) and whether they intended to quit smoking with the next six months, if at all.

Only 88 participants said they used e cigarettes, which are metallic tubes that allow liquid nicotine to be converted into a flavored inhalable vapor without the use of combustion.

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Participants were asked the same questions at the one year follow up, with only those answering both sets of questions included in the study.

The researchers found e cigarette smokers at baseline were not significantly less likely to quit smoking regular cigarettes one year later than people who did not use the products.

While 13.5 percent of the total study pool quit smoking, only nine of the 88 e cigarette smokers quit.

“There was no association between having tried an e cigarette and quitting smoking at one year follow up,” study author Dr. Rachel A. Grana, a postdoctoral scholar at UCSF School of Medicine, told CBS News’ Adriana Diaz.

E cigarette smokers overall did not express more intent to quit in their initial baseline interviews than other adults surveyed. E cigarette use also did not reduce the number of regular cigarettes smoked.

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While the study had limitations in the small numbers of participants, the authors said the research adds evidence that e cigarettes won’t make more people likely to quit. They also suggested regulators should prohibit advertising e cigarettes as a way to help people quit smoking until scientific evidence shows that’s the case.

“Because e cigarettes are unregulated, consumers do not know what they are putting into their bodies and there have been no long term studies of the health effects,” said Grana.

This isn’t the first study warning that e cigarettes may not as effective at stopping smoking as proponents have said. Earlier this month, a study in JAMA Pediatrics also from UCSF researchers concluded that e cigarettes may be a “gateway” to smoking real cigarettes for middle and high school students, based on increasing rates gleaned from surveys conducted in 2011 and 2012 on separate groups of students.

That study was met with criticisms from experts who said the study authors may have had “an axe to grind” and that the study’s conclusions were too broad.

Unlike that study, this research followed the same participants for a year, but the new research was met with similar criticisms over its limitations.

“We need solid data that’s based on solid science before we make decisions,” Dr. Michael Siegel, a community health researcher at the Boston University School of Public Health who was not involved with the study, told Reuters Health. The study didn’t look at why the smokers used e cigarettes, or how long they used them. “I hope no one would take this research letter and make any conclusion based on it,” he said.

“This study has problems,” Dr. Tom Glynn, director of Cancer Science and Trends at the American Cancer Society, told the Washington Post. “What’s interesting is even the authors talk about the limitations.”

Uncertainties over health effects from e cigarettes have led to bans on using the products in public places in major cities including Los Angeles, Chicago and New York.

Selby, sweanor & hughes: e-cigarettes could save the government billions

Camel, marlboro, winston, salem cigarette lighters

Innovation is a powerful thing. It has dramatically increased our quality of life, and the entrepreneurial spirit behind it continues to amaze us. If someone from 1964 were to see the computers, automobiles or medical diagnostics we have today, they would be astounded. But former U.S. surgeon general Luther Terry, who released the first ground breaking Report of the Surgeon General on Smoking and Health 50 years ago, would be saddened that cigarettes have not appreciably changed. They are still the same deadly and defective delivery system for nicotine and they remain, by far, the leading cause of preventable death, despite sound policy and improved treatment.

Rowan Warr Hunter E cigarettes Freedom to vape

If you want to understand what life is like for the Canadian entrepreneurs who are seeking to serve the growing demand for electronic cigarettes, consider me. My family and I own an online vaping business, along with a brick and mortar store located in Trenton, Ont.

There are four of us involved in the operation, with a total of 90 years of smoking traditional cigarettes between us. All of us have been smoke free for close to three years since we started vaping. Each one of us had tried every available cessation product on the market (medications, patches, gum, inhalers, cold turkey, hypnosis and acupuncture) with zero success at leaving cigarettes behind. One by one, we each switched to electronic cigarettes, and one by one each of us tossed out our ashtrays and lighters in favour of batteries and clearomizers. We were so impressed with our own success that we opened our business in 2012.

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Although there has been little to no innovation in cigarettes (evidence suggests they may actually be more harmful today than they were in the past), there have been great advances in potentially massively less harmful ways to deliver nicotine to the body, such as electronic cigarettes. Unfortunately, Health Canada s policy to these game changing devices has been confused, to say the least.

We have known for decades that smokers smoke for the nicotine, but die from the smoke. It is the latter that is the overwhelming cause of the cancers, as well as heart and lung diseases. In other words, it s the smoke, stupid. Were we to ingest caffeine by smoking rather than brewing tea leaves, the result would likely be the same. Approximately five million Canadians (one in five adults) continue to smoke cigarettes and get exposed to roughly 7,000 chemicals, including 60 that cause cancer. Others face health risks due to second hand smoke. Many treatments for nicotine addiction, including nicotine gums and patches, are more effective than quitting cold turkey, but still not optimal.

Failure to distinguish between the nicotine and the smoke leads society to miss a huge opportunity to address the seemingly intractable problems associated with cigarette smoking. The quit or die approach is unethical. It is akin to thinking that anyone who drove a car the 1960s, when there were much less stringent safety standards, should totally forgo driving, rather than have easy access to alternate, potentially less risky, products.

Entrepreneurs have found a way to meet the needs those unable, or unwilling, to forgo nicotine by developing, marketing and selling products that can deliver the drug in ways that promise to reduce the associated health risks, simply by getting rid of the smoke. Electronic cigarettes, which deliver nicotine in a combustion free vapour, are currently the most visible example. But these products are just the beginning of what has the potential to be a tsunami of innovation that could do to smoking what sanitation did to cholera. The products on the market today are just the beginning.


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Over a billion smokers worldwide are spending over $800 billion a year on cigarettes. The desire for a safer alternative, however, has led to massive growth in e cigarette sales. The private sector has an incentive to meet this demand, and if it’s done right, we could have a self funding public health revolution, with the potential to save the health care system billions of dollars by reducing the prevalence of diseases caused by inhaling smoke.

This has happened before. Only a couple of decades before that first surgeon general’s report, stomach cancer was the leading cause of cancer deaths. But within 50 years, it had been relegated to a minor cause of mortality. This was largely due to refrigeration. Manufacturers were able to harness the technology and innovate to make the products more consumer friendly, promoting healthier diets and the subsequent reduction in stomach cancer cases. Such actions by the private sector are easily replicable because they are profitable and thus don’t require government subsidies. We now have the potential to virtually eliminate lung cancer and many other smoking related diseases. Such a revolution in public health would be among the biggest in history. It would work with, rather than against, the market to make combustible tobacco obsolete.

Unfortunately, in Canada, the legal framework cannot cope well with innovation in this domain and can only see nicotine in terms of its past as being either a “tobacco product” or a “medicine.” It appears that Health Canada decided that since e cigarettes were not a tobacco product, they must be a medicine. As a result, the agency banned e cigarettes that contain nicotine, because they did not meet the exacting standards for medicines. E cigs, of course are not a medicine, but rather a replacement consumer product with the potential to dramatically reduce health risks.

There are, of course, risks in any policy changes, but the status quo, which equates to another million Canadian dying from smoking in the next 25 years, must be the talisman from which alternative policy approaches are judged.

A legitimate Health Canada monitored marketplace would be a worthy goal

To maximize the benefits of innovation, we need fit for purpose regulations aimed at harnessing market forces for the greatest possible reduction in smoking related diseases. Governments have a responsibility to enact progressive regulations that allow citizens to reduce their exposure to dangerous products, when viable alternatives become available.

As with any policy measure, we need to find a correct balance, and we need to deal effectively with any unintended consequences (no one wants to sell nicotine products to kids, for instance), and a legitimate Health Canada monitored marketplace would be a worthy goal. What should be the blinding reality in all of this is that it is not often that we can empower entrepreneurs to save lives, while creating jobs, paying taxes and very possibly creating new, world class Canadian companies. Since when is there a problem with doing well by doing good?

National Post

Dr. Peter Selby is associate professor in the departments of Family and Community Medicine and Psychiatry and the Dalla Lana School of Public Health, University of Toronto and Chief Addictions Division CAMH. David Sweanor is an adjunct professor of law at the University of Ottawa. Dr. John R. Hughes is a professor at the University of Vermont School of Medicine.