Posted on September 13, 2023 By Colin
A COCHRANE REVIEW published today found high-quality evidence that nicotine vapes and varenicline (Champix) are the two most effective single treatments for quitting smoking available in Australia. The study also found, “no clear evidence that either treatment increased serious side effects.
The study analysed 319 randomised controlled trials of all medications (over 150,000 patients) used to help smokers quit and compared the results in a “network’ meta-analysis.
Cochrane reviews are the gold-standard for determining whether a medical treatment is effective and adhere to rigorous standards to ensure accuracy
The study found that for every 100 people who use vapes to quit, 10-19 are likely to succeed after 6 months or more.
However, in real-world settings, vapes are likely to be even more effective. Vapes are often successful in smokers who do not intend to quit ("accidental quitters") and play an important role in relapse prevention. Vapes also often have increasing quit rates over time as users become more familiar with the product, often beyond the time limits of randomised controlled trials.
A 2022 Cochrane review also found that vaping was significantly more effective than nicotine replacement therapies, such as the nicotine patch and gum.
The findings of the Cochrane review indicate that vaping could play a major role in reducing smoking, Australia’s leading preventable cause of death and illness. Smoking is notoriously hard to quit and most smokers try repeatedly to quit and fail. The most effective treatments should be freely available and their use encouraged.
It is therefore hard to reconcile the Cochrane findings with the opinions of the Health minister who announced today he is committed to "stamp out vaping". He thinks vaping is a “threat to public health” and “poses a major threat to Australia’s success in tobacco control”
The Cochrane findings are also in harsh contrast with the advice of many of Australia’s health and medical organisations:
The disinformation on vaping by the Australian Health Minister and health and medical organisations is in stark contrast to advice from other governments such as New Zealand and the UK
The New Zealand Ministry of Health says, “Smokers who have tried other methods of quitting without success could be encouraged to try e-cigarettes to stop smoking.”
The National Health Service in the UK says, “Many thousands of people in the UK have already stopped smoking with the help of an e-cigarette.” Vapes are, “far less harmful than cigarettes, and can help you quit smoking for good".
As a result, smoking is declining rapidly in those countries. Over the last 4 years, smoking rates fell by 39% in New Zealand and 33% in the UK. In Australia smoking declined by 5% over the same period
Honest advice from Australian authorities would increase the use of vapes and reduce smoking-related death and disease. It is the least we can expect from health authorities whose role is to improve, not obstruct, public health.
Lindson N et al. Pharmacological and electronic cigarette interventions for smoking cessation in adults: component network meta-analyses (Review). September 2023
E-Cigarettes And The Cochrane Review. American Council on Science and Health, 18 September 2023