UC San Diego Claims No Evidence for Quit-Smoking Via E-Cigarettes, Medicines or Cold Turkey

 

The anti-tobacco journal Tobacco Control just published another e-cigarette study by Dr. John Pierce and co-workers from the University of California San Diego (here).  I’ve dissected Pierce’s previous work here, here and here. 

This time, Pierce’s group used the FDA’s Population Assessment of Tobacco and Health Survey to determine what aids current and former smokers used to quit and how successful they were.  As in his earlier work, Pierce counted anyone who took even one puff on a cigarette as a failed quitter.   

First, let’s look at the main results, from Tables 3 and 4 of the study

 

From Pierce Table 3. Abstinence From Cigarettes (Even 1 Puff) for 12+ Months Among Smokers Who Used Various Products in their Last Quit Attempt
Product	Number	Percent Abstinent
E-cigarettes	319	9%
Other tobacco	58	14%
Any medicine	489	16%
Nothing	1,613	19%
All	2,479	17%

 

From Pierce Table 4. Abstinence From Cigarettes (Even 1 Puff) for 12+ Months Among Recent Former Smokers Who Used Tobacco Products
Product	Number	Percent Abstinent
E-cigarettes
Daily	96	45%
Nondaily	52	29%
Other tobacco
Daily	65	38%
Nondaily	99	43%
No tobacco	576	53%

 

Dr. Pierce provided generous click-bait quotes to the media, including the following:

“This is the first time we found e-cigarettes to be less popular than FDA-approved pharmaceutical aids, such as medications or the use of patches, gum, or lozenges.”

To render e-cigarettes as “less popular,” Dr. Pierce first gamed the numbers by combining smokers trying any prescription medicine and/or six different nicotine products, four of which are available over-the-counter. 

Furthermore, who can blame American smokers for vapor’s declining popularity?  They have been told incessantly, and incorrectly, that e-cigarettes are as or more dangerous than combustible cigarettes. 

Dr. Pierce opined, “There's no evidence that the use of e-cigarettes is an effective cessation aid,” and he doubled down on that position in an email to United Press International: “We are not finding any evidence in this very large nationally representative study that smokers who switch to get their nicotine from e-cigarettes are less likely to relapse back to cigarette smoking.”  

Frankly, if one sees no evidence for e-cigarettes in the above tables, one would have to conclude that there's no evidence that anything is an effective cessation aid. 

What did the Pierce study actually document in comparing e-cigarettes and FDA-approved medicines?  Co-author Karen Messer, Ph.D., said, “using e-cigarettes to help a quit attempt resulted in seven fewer successful quitters [out of 100] than were seen with approved pharmaceutical cessation aids.”

Drs. Pierce and Messer emphasized those seven for a reason: their one-puff abstinence rate was only 9% for e-cigarette users versus 16% for medicine users.  Both aids helped some smokers quit, but they failed 91% and 84% of the smokers who tried them.

With failure rates like these, smokers who are desperate to quit should have access to every safer option.  It doesn’t matter which quit aid smokers use, so long as it works for them.  Smokers also deserve far more rigorous analysis and forthright counsel than that provided by abstinence-only activists.