Tobacco Harm Reduction Network (Thailand)

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E3 Trial: E-Cigarettes Plus Counseling More Effective Than Counseling Alone in Smoking Cessation

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Smokers who received smoking cessation counseling and used electronic cigarettes (e-cigarettes) containing nicotine were more than twice as likely to successfully quit smoking compared with those who received counseling but did not use e-cigarettes, according to results of a Late-Breaking Clinical Trial presented March 30 at ACC.20/WCC.

Mark J. Eisenberg, MD, MPH, FACC, et al., studied 376 participants (average age, 53 years) who had smoked for an average of 35 years and smoked an average of 21 cigarettes a day before the study. All participants were motivated to quit. One-third of the participants received e-cigarettes containing nicotine, one-third received e-cigarettes without nicotine and one-third did not receive an e-cigarette. Over the course of the study, all participants received about 100 minutes of counseling with guidance on quitting smoking. Those receiving e-cigarettes were instructed to vape as much as they felt they needed.

Researchers stopped enrollment early (after reaching 77% of target enrollment) due to a disruption in the supply of commercial e-liquid used in the study. The study was underway before reports of vaping-linked lung injuries, and no such lung injuries occurred among study participants.

The results showed that at 12 weeks, 21.9% of participants given nicotine-containing e-cigarettes had quit smoking, 17.3% of participants given non-nicotine e-cigarettes had quit and 9.1% of participants given only counseling had quit. Overall, those using nicotine-containing e-cigarettes were 2.4-times more likely to quit than those who did not vape at all.

Researchers also found that among participants who did not quit smoking, their daily use of cigarettes was cut in half or more by 61% of those vaping with nicotine, 45.7% of those vaping without nicotine and 30.9% of those receiving counseling alone

“These findings show that nicotine e-cigarettes are effective for smoking cessation in the short term,” says Eisenberg. “Vaping is much more effective than counseling, though it’s not a magic bullet for smoking cessation.”

The study will continue to collect data for one year to assess whether these effects persist over time. Researchers cautioned that the health effects of e-cigarettes are unknown, and they should not be used for any purpose other than smoking cessation.

“It is important to note that in this study the participants were chronic smokers, who were highly motivated to discontinue cigarettes in favor of a non-smoking form of nicotine, says Kim A. Eagle, MD, MACC, editor-in-chief of “The dose chosen was determined by the number of cigarettes used. This design acknowledges that nicotine is a drug that is highly addictive and supports the concept that substituting a less harmful type of nicotine such as gum, patch or e-cigarette, offers one mechanism by which to help smokers quit.”

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