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E-cigarettes in smoking cessation: A harm reduction perspective

Abstract:

Electronic cigarettes (e-cigarettes) are novel devices that simulate aspects of cigarette smoking and deliver nicotine to users. Evidence for their efficacy in smoking cessation, based on several randomised controlled trials of older devices, suggests a modest effect. They appear to be far less harmful than tobacco smoking, but the health effects of long-term use are unknown. Possible adverse population effects of widespread e-cigarette use, such as renormalising smoking behaviour, are a concern but are unsupported by current evidence. Regulatory authorities have been unclear on how to treat these products and a variety of regulatory approaches are being adopted in different jurisdictions. E-cigarette use is now common, so healthcare professionals should be knowledgeable about them. If patients who smoke tobacco are unwilling to quit, or cannot succeed using currently available evidencebased approaches, e-cigarettes may be considered as an option after discussing the limitations of current knowledge.