Cochrane Updates The Evidence

The sharing of this Cochrane Review of electronic cigarettes for smoking cessation across Parliament may prove to be very important due to some of the key aspects of vaping the Cochrane team looked at, namely:

• How long people continue to use e-cigarettes after a quit attempt
• The impact and role of e-cigarette flavourings in supporting people to quit
• Whether levels of potentially harmful chemicals and toxicants vary between people who have quit smoking and switched completely to e-cigarettes, those who continue to smoke, those who use e-cigarettes and cigarettes and those who quit without e-cigarettes

The Cochrane Review is the product of a global, independent network of researchers, professionals, patients, carers, and people interested in health. They look at emerging evidence and assess it, factoring it into the living review if it meets high-quality evidence thresholds.

As Action on Smoking and Health says: “Cochrane's reach, rigour, and independence from any commercial or conflicted funding mean its reviews are widely regarded as the gold standard for authoritative, reliable health research.”

When it comes to how long people vape for, ASH reports: “Just over half (54%) were still using an e- cigarette 6 months later. Among those who had successfully stopped smoking, the proportion still using e-cigarettes 6 months later was even greater at 70%.”

Some hypothesise that this is why vaping works better than traditional nicotine replacement products. ASH acknowledges: “If on-going vaping prevents relapse, this would likely provide a benefit.”

Risk? What risk?

The Cochrane Review found “no evidence of serious harm from using e-cigarettes for stopping smoking”. 

It goes on to add that reliable evidence on their long-term safety is still lacking, but states: “However, concerns about the safety of long-term e-cigarette use must be weighed against the relative harm that would be caused by continuing to smoke.”

Flavours

With the Government possibly considering flavour restrictions in the future, Cochrane says strong evidence on the impact e-cigarette flavourings have on someone's likelihood of stopping smoking is still lacking.

Exposure to potentially harmful chemicals and toxicants

“Levels of carbon monoxide (CO) were significantly lower among people who stopped smoking using an e-cigarette than among people who continued to solely smoke combustible cigarettes or in people using e-cigarettes while continuing to smoke.

“Levels of other tobacco-associated toxicants were also significantly lower among people using e-cigarettes compared to people who continued smoking. Levels of most toxicants were lower among people solely using e-cigarettes than in people using both e-cigarettes and combustible cigarettes. These findings show the potential benefits of switching to e-cigarettes for reducing exposure to potentially harmful toxicants. The evidence did not show that people who were using e-cigarettes and smoking (dual use) were exposed to more harmful toxicants than those only smoking.”

They summarise:

• E-cigarettes are an effective stop smoking tool and are less harmful than combustible cigarettes. 
• We need longer-term data to see whether the 54% of who people who use e-cigarettes for longer than 6 months continue to use them beyond this point. 
• More data is needed on any potential long-term effects of using e-cigarettes. 
• We need more information on the role of e-cigarette flavours in helping people to quit combustible cigarettes and to stay quit. 
• Levels of toxicants are lower among people who use e-cigarettes than in people who smoke combustible cigarettes. 
• To reduce exposure to harmful toxicants, people should stop smoking altogether. There was no evidence that using an e-cigarette while smoking (dual use) increased people's exposure to harmful toxicants compared to only smoking. 

Dave Cross

Journalist at POTV

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Dave is a freelance writer; with articles on music, motorbikes, football, pop-science, vaping and tobacco harm reduction in Sounds, Melody Maker, UBG, AWoL, Bike, When Saturday Comes, Vape News Magazine, and syndicated across the Johnston Press group. He was published in an anthology of “Greatest Football Writing”, but still believes this was a mistake. Dave contributes sketches to comedy shows and used to co-host a radio sketch show. He’s worked with numerous start-ups to develop content for their websites.