In the Journals

E-cigarettes unhelpful for smoking cessation among patients with cancer

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October 13, 2014

A study of patients with cancer who smoke showed those who used electronic cigarettes were more nicotine-dependent than nonusers.

Those who used e-cigarettes also were equally or less likely to have quit smoking traditional cigarettes than nonusers.

E-cigarette use among tobacco-dependent individuals with cancer has increased during the past 2 years, consistent with increased use among the general population.

To examine whether e-cigarette use was associated with improved smoking cessation outcomes, Jamie S. Ostroff, PhD, chief of the behavioral sciences service and director of the tobacco treatment program at Memorial Sloan Kettering Cancer Center, and colleagues analyzed all 1,074 patients with cancer who underwent evaluation as part of the hospital’s tobacco cessation program in 2012 and 2013.

Through this program, patients began an evidence-based tobacco cessation treatment plan that consisted of behavior modification and appropriate smoking cessation medication.

At enrollment, nicotine dependence was found to be more prevalent in the e-cigarette users, and these patients also reported more previous attempts to quit smoking. Moreover, e-cigarette users exhibited a higher prevalence of thoracic cancer and head and neck cancers.

After 6 to 12 months of enrollment, researchers collected preliminary data regarding tobacco cessation outcomes. Patients also reported their use of e-cigarettes within the previous 30 days.

Researchers determined use of e-cigarettes among these patients increased nearly more than threefold — from 10.6% to 38.5% — from 2012 to 2013. Seven-day abstinence rates were comparable between e-cigarette users (44.4%) and nonusers (43.1%).

A complete case analysis revealed that, at follow-up, failed cessation attempts were as common among e-cigarette users as nonusers (OR=1; 95% CI, 0.5-1.7). Based on an intention-to-treat analysis, e-cigarette users were twice as likely to have continued smoking at follow-up as nonusers (OR=2; 95% CI, 1.2-3.3).

“Controlled research is needed to evaluate the potential harms and benefits of e-cigarettes as a potential cessation approach for cancer patients,” Ostroff said in a press release. “In the meantime, oncologists should advise all smokers to quit smoking traditional combustible cigarettes, encourage use of FDA-approved cessation medications, refer patients for smoking cessation counseling, and provide education about the potential risks and lack of known benefits of long-term e-cigarette use.”

Disclosure: The researchers report no relevant financial disclosures.

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