Comprehensive review suggests e-cigarettes unlikely to increase quitting rates in Australia

Quit welcomes the release of a summary report of a body of work from the Australian National University, which includes a review of national and international data on the effectiveness of e-cigarettes for smoking cessation. 

A key finding is that there is insufficient evidence that nicotine-delivering e-cigarettes are more effective in helping people to quit compared to any other intervention or even ‘cold-turkey’.

According to Dr Sarah White, director of Quit, national and international data and research are converging on the view that e-cigarettes are not “the silver bullet” to help a large number of Australians quit smoking. 

“Recently there has been a coordinated advocacy campaign and political lobbying by e-cigarette companies and allies that has highlighted the stories of people who have used e-cigarettes to quit. 

“The reality, though, is that most people who have used e-cigarettes have not successfully quit. The silent majority includes people for whom e-cigarettes have not worked for quitting, who are using e-cigarettes and cigarettes interchangeably and, worst of all, who have started or re-started smoking because of e-cigarettes.”

Dr White said that there was an emerging consensus that – as well as increasing the risk of never smokers starting to smoke – e-cigarettes were leading former smokers back to smoking.  

“What is becoming evident from international studies is that former smokers who had used e-cigarettes were twice as likely to relapse and start smoking again,” she said.

The program of work by the ANU was led by one of Australia’s best epidemiologists, Professor Emily Banks and commissioned by the Australian Government. The study team noted there were few randomised clinical trials testing the effectiveness of e-cigarettes for quitting and their quality was generally not high. The best of these trials found that e-cigarettes were more effective than nicotine replacement therapy, but 80% of the people who used e-cigarettes were still addicted to nicotine one year later.

“At the end of the day, it seems that e-cigarettes are keeping people addicted to nicotine or are 
re-triggering a nicotine addiction. What we want to see is people who smoke breaking completely free from nicotine addiction and not being enslaved to commercial interests who just want people to buy their products.

“This report validates the RACGP guideline advice that e-cigarettes should be considered a last resort for people wanting to quit and validates the Australian Government’s approach to limiting availability of e-cigarettes for recreational use,” Dr White said.

Quit Victoria is a partnership between VicHealth, the State Government of Victoria and Cancer Council Victoria.