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Effectiveness of the Electronic Cigarette: An Eight-Week Flemish Study with Six-Month Follow-up on Smoking Reduction, Craving and Experienced Benefits and Complaints

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  • Karolien Adriaens

    (Faculty of Psychology and Educational Sciences, KU Leuven—University of Leuven, Tiensestraat 102, 3000 Leuven, Belgium
    These authors contributed equally to this work.)

  • Dinska Van Gucht

    (Faculty of Psychology and Educational Sciences, KU Leuven—University of Leuven, Tiensestraat 102, 3000 Leuven, Belgium
    Thomas More University College Antwerp, Molenstraat 8, 2018 Antwerp, Belgium
    These authors contributed equally to this work.)

  • Paul Declerck

    (Department of Pharmaceutical and Pharmacological Sciences, KU Leuven—University of Leuven, O&N II Herestraat 49, 3000 Leuven, Belgium)

  • Frank Baeyens

    (Faculty of Psychology and Educational Sciences, KU Leuven—University of Leuven, Tiensestraat 102, 3000 Leuven, Belgium
    These authors contributed equally to this work.)

Abstract

Background: Smoking reduction remains a pivotal issue in public health policy, but quit rates obtained with traditional quit-smoking therapies remain disappointingly low. Tobacco Harm Reduction (THR), aiming at less harmful ways of consuming nicotine, may provide a more effective alternative. One promising candidate for THR are electronic cigarettes (e-cigs). The aim of this study was to investigate the efficacy of second-generation e-cigs both in terms of acute craving-reduction in the lab and in terms of smoking reduction and experienced benefits/complaints in an eight-month Randomized Controlled Trial (RCT). Design: RCT with three arms. Methods: Participants (N = 48) unwilling to quit smoking were randomized into two e-cig groups and one control group. During three lab sessions (over two months) participants, who had been abstinent for four hours, vaped/smoked for five minutes, after which we monitored the effect on craving and withdrawal symptoms. eCO and saliva cotinine levels were also measured. In between lab sessions, participants in the e-cig groups could use e-cigs or smoke ad libitum, whereas the control group could only smoke. After the lab sessions, the control group also received an e-cig. The RCT included several questionnaires, which repeatedly monitored the effect of ad libitum e-cig use on the use of tobacco cigarettes and the experienced benefits/complaints up to six months after the last lab session. Results: From the first lab session on, e-cig use after four hours of abstinence resulted in a reduction in cigarette craving which was of the same magnitude as when a cigarette was smoked, while eCO was unaffected. After two months, we observed that 34% of the e-cig groups had stopped smoking tobacco cigarettes, versus 0% of the control group (difference p < 0.01). After five months, the e-cig groups demonstrated a total quit-rate of 37%, whereas the control group showed a quit rate of 38% three months after initiating e-cig use. At the end of the eight-month study, 19% of the e-cig groups and 25% of the control group were totally abstinent from smoking, while an overall reduction of 60% in the number of cigarettes smoked per day was observed (compared to intake). eCO levels decreased, whereas cotinine levels were the same in all groups at each moment of measurement. Reported benefits far outweighed the reported complaints. Conclusion: In a series of controlled lab sessions with e-cig naïve tobacco smokers, second generation e-cigs were shown to be immediately and highly effective in reducing abstinence induced cigarette craving and withdrawal symptoms, while not resulting in increases in eCO. Remarkable (>50 pc) eight-month reductions in, or complete abstinence from tobacco smoking was achieved with the e-cig in almost half (44%) of the participants.

Suggested Citation

  • Karolien Adriaens & Dinska Van Gucht & Paul Declerck & Frank Baeyens, 2014. "Effectiveness of the Electronic Cigarette: An Eight-Week Flemish Study with Six-Month Follow-up on Smoking Reduction, Craving and Experienced Benefits and Complaints," IJERPH, MDPI, vol. 11(11), pages 1-29, October.
    • Handle: RePEc:gam:jijerp:v:11:y:2014:i:11:p:11220-11248:d:41783
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    References listed on IDEAS

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    1. Pasquale Caponnetto & Roberta Auditore & Cristina Russo & Giorgio Carlo Cappello & Riccardo Polosa, 2013. "Impact of an Electronic Cigarette on Smoking Reduction and Cessation in Schizophrenic Smokers: A Prospective 12-Month Pilot Study," IJERPH, MDPI, vol. 10(2), pages 1-16, January.
    2. Konstantinos E. Farsalinos & Giorgio Romagna & Dimitris Tsiapras & Stamatis Kyrzopoulos & Vassilis Voudris, 2014. "Characteristics, Perceived Side Effects and Benefits of Electronic Cigarette Use: A Worldwide Survey of More than 19,000 Consumers," IJERPH, MDPI, vol. 11(4), pages 1-18, April.
    3. WHO World Health Organization, 2013. "Who Report On The Global Tobacco Epidemic, 2013," University of California at San Francisco, Center for Tobacco Control Research and Education qt5t06910t, Center for Tobacco Control Research and Education, UC San Francisco.
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    1. Socrates Yong-da Wu & Man Ping Wang & William H. Li & Antonio C. Kwong & Vienna W. Lai & Tai Hing Lam, 2018. "Does Electronic Cigarette Use Predict Abstinence from Conventional Cigarettes among Smokers in Hong Kong?," IJERPH, MDPI, vol. 15(3), pages 1-10, February.
    2. Qian Liu & Yu Liang & Siyi Wang & Zhongguo Huang & Qing Wang & Miaoyutian Jia & Zihang Li & Wai-Kit Ming, 2022. "Health Communication through Chinese Media on E-Cigarette: A Topic Modeling Approach," IJERPH, MDPI, vol. 19(13), pages 1-18, June.
    3. Cristina Russo & Fabio Cibella & Enrico Mondati & Pasquale Caponnetto & Evelise Frazzetto & Massimo Caruso & Grazia Caci & Riccardo Polosa, 2018. "Lack of Substantial Post-Cessation Weight Increase in Electronic Cigarettes Users," IJERPH, MDPI, vol. 15(4), pages 1-13, March.
    4. Melinda Pénzes & Márta Bakacs & Zoltán Brys & József Vitrai & Gergely Tóth & Zombor Berezvai & Róbert Urbán, 2021. "Vaping-Related Adverse Events and Perceived Health Improvements: A Cross-Sectional Survey among Daily E-Cigarette Users," IJERPH, MDPI, vol. 18(16), pages 1-15, August.
    5. Anastasia Moysidou & Konstantinos E. Farsalinos & Vassilis Voudris & Kyriakoula Merakou & Kallirrhoe Kourea & Anastasia Barbouni, 2016. "Knowledge and Perceptions about Nicotine, Nicotine Replacement Therapies and Electronic Cigarettes among Healthcare Professionals in Greece," IJERPH, MDPI, vol. 13(5), pages 1-25, May.
    6. Pietro Ferrara & Saran Shantikumar & Vítor Cabral Veríssimo & Rafael Ruiz-Montero & Cristina Masuet-Aumatell & Josep Maria Ramon-Torrell & the EuroNet MRPH Working Group on Electronic Cigarettes and T, 2019. "Knowledge about E-Cigarettes and Tobacco Harm Reduction among Public Health Residents in Europe," IJERPH, MDPI, vol. 16(12), pages 1-13, June.
    7. Roberta Pacifici & Simona Pichini & Silvia Graziano & Manuela Pellegrini & Giuseppina Massaro & Fabio Beatrice, 2015. "Successful Nicotine Intake in Medical Assisted Use of E-Cigarettes: A Pilot Study," IJERPH, MDPI, vol. 12(7), pages 1-9, July.
    8. Karolien Adriaens & Dinska Van Gucht & Frank Baeyens, 2018. "IQOS TM vs. e-Cigarette vs. Tobacco Cigarette: A Direct Comparison of Short-Term Effects after Overnight-Abstinence," IJERPH, MDPI, vol. 15(12), pages 1-20, December.
    9. Dinska Van Gucht & Karolien Adriaens & Frank Baeyens, 2017. "Online Vape Shop Customers Who Use E-Cigarettes Report Abstinence from Smoking and Improved Quality of Life, But a Substantial Minority Still Have Vaping-Related Health Concerns," IJERPH, MDPI, vol. 14(7), pages 1-11, July.
    10. Anca Maria Pop & Raluca Coroș & Alexandra Mihaela Stoica & Monica Monea, 2021. "Early Diagnosis of Oral Mucosal Alterations in Smokers and E-Cigarette Users Based on Micronuclei Count: A Cross-Sectional Study among Dental Students," IJERPH, MDPI, vol. 18(24), pages 1-10, December.
    11. Riccardo Polosa & Pasquale Caponnetto & Fabio Cibella & Jacques Le-Houezec, 2015. "Quit and Smoking Reduction Rates in Vape Shop Consumers: A Prospective 12-Month Survey," IJERPH, MDPI, vol. 12(4), pages 1-11, March.
    12. Martijn Van Heel & Dinska Van Gucht & Koen Vanbrabant & Frank Baeyens, 2017. "The Importance of Conditioned Stimuli in Cigarette and E-Cigarette Craving Reduction by E-Cigarettes," IJERPH, MDPI, vol. 14(2), pages 1-18, February.

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