26/06/2014
As of June 2014, The World Health Organization (WHO) was assessing the available evidence concerning e-cigerattes.[14] They had previously stated in July 2013 that the efficacy of electronic ci******es in aiding smoking cessation had not been demonstrated and recommend that "consumers should be strongly advised not to use" electronic ci******es unless a reputable national regulatory body has found them safe and effective.[8] The US Government smoking cessation site, smokefree.gov stated the efficacy of electronic ci******es in aiding smoking cessation has not been demonstrated and don’t recommend them to use.[15]
The concept of harm reduction has largely been controversial in the public health approach of to***co control.[16] A 2011 review article states how electronic ci******es may aid in smoking cessation and may likely be more effective than traditional pharmacotherapy, as the physical stimuli of holding and puffing on the electronic cigarette may better reduce short-term cravings.[16] The review found no studies that directly measured the effectiveness of electronic ci******es in smoking cessation, and examined two published studies that indirectly consider the issue by measuring the effect of the product on cravings and other short-term indicators.[16] A 2014 review asserted how electronic ci******es may be a reasonable substitute for cigarette smoking.[3] The review also states that even individuals that did not intend to quit smoking before being introduced to e-ci******es may subsequently do so.[3] Another 2014 review concluded that the benefit with respect to helping people quit smoking was uncertain.[5]
The American Association of Public Health Physicians (AAPHP) suggests those who are unwilling to quit to***co smoking or unable to quit with medical advice and pharmaceutical methods should consider other ni****ne containing products such as electronic ci******es and chewing to***co for long term use instead of smoking.[17]
The British Medical Association (BMA) reports there is a possibility for smoking cessation benefits, but has concerns that e-ci******es are less regulated than ni****ne replacement therapy (NRT), and that there is no peer reviewed evidence concerning their safety or efficacy. Recommendations point to a "strong regulatory framework" for e-cigarette distribution in order to ensure the safety, quality, and that marketing and sales are restricted to adults. The BMA encourages health professionals to recommend conventional ni****ne replacement therapies, but for patients unwilling to use or continue using such methods, health professionals may present e-ci******es as a lower-risk option than to***co smoking.[18]
A report commissioned by Public Health England concluded that there is large potential for health benefits when switching from to***co use to other ni****ne delivery devices such as electronic ci******es, but realizing the full potential requires regulation and monitoring to minimize possible risks.[6]
A 2012 review found electronic systems appear to generally deliver less ni****ne than smoking, raising the question of whether they can effectively substitute for to***co smoking over a long-term period.[19]
A 2013 randomized controlled trial found no difference in smoking cessation rates between e-ci******es with ni****ne, e-ci******es without ni****ne and traditional NRT patches.[20] There are some non-controlled studies which have reported possible benefit.[7]
Electronic ci******es were not regularly associated with trying to quit to***co among young people.[11] Adults most often used electronic ci******es as a replacement for to***co, although not invariably to quit.[11] The majority of e-cigarette users continue to smoke traditional ci******es.[2] Although the majority of youth using e-ci******es are dual users, some youth who used an e-cigarette have never tried a traditional cigarette.[2] Although some people have a desire to quit smoking by using e-ci******es, other common explanations for the use of these products are to evade smoke-free laws, to reduce harm from smoking [21] and to cut back on traditional ci******es, which may reinforce delaying or deterring to quit smoking.[2]
