The science on e-cigarettes is still young, adding to the confusion around the burgeoning $1.5 billion industry that the FDA will soon regulate. Absent federal oversight so far, some states and cities have enacted their own bans on the products, which deliver nicotine through a vaporized liquid instead of burning tobacco.
Researchers writing in JAMA Internal Medicine found that use of e-cigarettes was not associated with “greater rates of quitting cigarettes or reduced cigarette consumption” after one year. The authors reached the conclusion based on self-reported data from 949 smokers, which included 88 who used e-cigarettes.
Still, they’re the first to admit that their findings should be viewed with some caution. The study’s small sample size could have hurt their ability to draw a relationship between e-cigarettes and quitting smoking, they wrote. They also didn’t collect information on characteristics of use, such as motivation and frequency.
“Nonetheless, our data add to the current evidence that e-cigarettes may not increase rates of smoking cessation,” wrote authors Rachel Grana, Lucy Popova and Pamela Ling.
Mitchell Katz, editor of the research journal, acknowledges that the evidence on whether e-cigarettes help to stop smoking is “contradictory and inconclusive.” Still, he argues, there’s not enough evidence to claim that e-cigarettes do help people to quit.
“I agree with Grana and colleagues that sellers of e-cigarettes should not be able to advertise them as smoking cessation devices without sufficient evidence that they are effective for this indication,” Katz wrote.
Tom Glynn of the American Cancer Society, whose advocacy arm has lobbied for strict e-cigarette regulation, said he’s worried about the strong conclusion drawn by the study authors given the sample size and their own hedging.
“This study has problems,” said Glynn, ACS director of Cancer Science and Trends. “What’s interesting is even the authors talk about the limitations.”
There hasn't been much previous research on this topic. A September study out of New Zealand found that e-cigarettes were "modestly effective" at helping people to quit smoking, about on par with nicotine patches.
Other recent studies have been bearish on e-cigarettes’ potential as a smoking cessation tool. A study published earlier this month in JAMA Pediatrics found that middle and high school students who smoked e-cigarettes were also more likely to smoke cigarettes. But experts were also split on the meaning of those findings, the New York Times reported.
Ultimately, the FDA is expected to soon issue regulations on how the products may be marketed and sold. The fierce lobbying battle that’s played out in recent months shows just how high the stakes are for the industry’s future.