This study investigated whether e-cigarettes are more effective than nicotine patches at helping smokers to quit.
Methods: A pragmatic randomized-controlled superiority trial included adult (≥18 years) smokers wanting to quit were stratified by ethnicity, sex, and level of nicotine dependence in a 4:4:1 ratio to 16 mg nicotine e-cigarettes, nicotine patches (21 mg patch, one daily), placebo e-cigarettes (no nicotine), from 1 week before until 12 weeks after quit day, with low intensity behavioural support via voluntary telephone counselling.
Results: 657 people were randomized (289 to nicotine e-cigarette, 295 to patches, and 73 to placebo e-cigarette) and were included in the intention-to-treat analysis. At 6 months, verified abstinence was 7.3% (21 of 289) with nicotine e-cigarettes, 5.8% (17 of 295) with patches, and 4.1% (three of 73) with placebo e-cigarettes (risk difference for nicotine e-cigarette vs patches 1.51; for nicotine e-cigarettes vs placebo e-cigarettes 3.16). No significant differences in adverse events were noted, with 137 events in the nicotine e-cigarettes group, 119 events in the patches group, and 36 events in the placebo e-cigarettes group.
Conclusion: E-cigarettes, with or without nicotine, were modestly effective at helping smokers to quit, with similar achievement of abstinence as with nicotine patches, and few adverse events.