What should I advise a patient who is asking whether they should use an e-cigarette?
Evidence favours a combination of behavioural support and pharmacotherapy as providing the highest chance of successfully quitting tobacco use.
There are now significant numbers of people using e-cigarettes, with many finding them useful for quitting cigarette use or cutting down.
While the safest option is to use neither tobacco nor e-cigarettes, there is no situation in which it is safer to continue smoking than to use an e-cigarette.
The clearest benefit to health will likely be achieved for patients who are using e-cigarettes to stop smoking tobacco altogether. If individuals continue to smoke tobacco, there are unlikely to be major benefits from using e-cigarettes.
All smokers, including those who wish to use e-cigarettes as an aid to quit smoking, should be able to access the support of local smoking cessation services, and be aware of the full range of smoking cessation interventions and support available.
Are e-cigarettes effective in helping people stop smoking?
E-cigarettes are now the most popular aid used in attempts to quit smoking. Many individuals who have attempted and failed to quit smoking using other methods have reported finding e-cigarettes useful in quitting or cutting down.
The evidence-base in this area remains weak, though most studies demonstrate a positive relationship between the use of e-cigarettes and smoking cessation.
Combining e-cigarettes with behavioural support is likely to increase the chance of successfully quitting tobacco use.
Is it safe to use an e-cigarette in the long-term?
In the absence of long-term studies it is not possible to be certain about the long-term health risks, but there is growing consensus that use of e-cigarettes is significantly safer than smoking.
Unlike cigarette smoking, e-cigarette use does not expose users to the products of combustion, and most of the toxicants causing smoking-related disease are absent or significantly reduced in e-cigarette vapour.
Indications to date are that complete switching can lead to improvements in the levels of toxins and carcinogens in urine similar to that in smokers who switch completely to NRT (nicotine replacement therapies).
Should e-cigarettes be used in pregnancy?
The Smoking in Pregnancy Challenge Group – a coalition of health organisations – have highlighted that although little research has been conducted into the safety of e-cigarettes in pregnancy, they are likely to be significantly less harmful to a pregnant woman and her baby than smoking cigarettes. The group suggest that while licensed NRT are the recommended option, if a pregnant woman chooses to use an e-cigarette to stay smoke free, she should not be discouraged from doing so.
