Posted on October 25, 2021 By Colin
Vaping nicotine is more effective than all the available stop-smoking medicines, varenicline, nicotine replacement therapy and bupropion, according to a comprehensive analysis funded by the prestigious UK National Institute for Health Research.
The study analysed 171 randomised controlled trials (RCTs) using a technique called a "network meta-analysis". This allows treatments to be compared with each other without having to test them head-to-head in the one trial.
In order of effectiveness the results were:
1. Electronic cigarettes (most effective)
2. Varenicline (Champix)
3. Nicotine replacement therapy
4. Bupropion (Zyban) (least effective)
This analysis of RCTs is supported by other evidence that vaping is effective from observational studies, population studies, declines in national smoking rates and millions of personal stories.
The most effective treatment of all was a combination of varenicline and nicotine replacement therapy. This is available in Australia although it is rarely used. Only one of these medicines is subsidised at any one time by the Pharmaceutical Benefits Scheme (PBS).
It is generally accepted that smokers should quit as soon as possible with the most effective treatment available. As Professor Robert West states in the journal Addiction
It is vital for smokers to stop at the earliest possible opportunity, and for every quit attempt to have the best possible chance of success
However, in Australia, vaping is only endorsed once all the less effective options have been tried. This usually results in repeated failed attempts to quit over many years, during which further harm and suffering occurs and years of life are lost.
One of the favoured arguments by anti-vaping groups is that we don’t know if vaping works as a quitting aid and that smokers should use 'evidence-based' treatments.
Well, not only is vaping nicotine effective, but we have the evidence and it is the most effective single treatment
Further studies on vaping are needed to confirm exactly how effective it is, but we have enough evidence to know that it works, and it works well.
Organisations such as the Heart Foundation and QuitVic and the World Health Organisation which claim that there is a lack of evidence for vaping as a quitting aid need to review their position statements. (Spoiler: they won't)
The analysis also found that professional support increases success with all treatments, suggesting that getting advice and support from a health professional will increase quit rates further when vaping.
The National Institute for Health Research is funded by the UK Department of Health and Social Care to provide health research for the UK National Health Service.
Thomas KH, Dalili MN, López-López JA, Keeney E, Phillippo D, Munafò MR, et al. Smoking cessation medicines and e-cigarettes: a systematic review, network meta-analysis and cost-effectiveness analysis. Health Technol Assess 2021;25(59).