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New study confirms combining vaping with nicotine patch is more effective

Posted on September 10, 2019


New evidence from a large New Zealand study has found that combining  nicotine vaping with nicotine patches can help more smokers quit, and could help hundreds of thousands of Australian smokers to break the deadly habit compared to just using patches alone.

The large randomised controlled trial is the first to test the safety and effectiveness of combining both treatments compared to nicotine patches alone. The study was published today in the leading medical journal The Lancet today. The lead investigator is Professor Natalie Walker from the University of Auckland.

1,124 adult smokers were randomly allocated to three groups:

  • nicotine patches only
  • nicotine patches plus nicotine-free e-cigarettes, and
  • nicotine patches plus an e-cigarette with 18mg/ml of nicotine

Participants were advised to start using their study products two weeks before their quit date and continue for a further 12 weeks. They were also offered a low level of telephone support.

The study found that after 6 months, 7% of smokers who used vaping combined with nicotine patches had quit, compared to 2% of those using patches alone.

All self-reported quitting was verified by carbon monoxide breath tests.

The study also found that 4% of smokers who used nicotine-free vaporisers with patches also quit, showing that the use of nicotine-free vaping combined with patches can also improve results, compared to patches alone.

Although the quit rates were not high, the authors calculated that in Australia, if vaping with nicotine was legalised, the combined therapy could potentially lead to 130,000 to 260,000 more people becoming smoke-free than if only patches were used.

The study began in March 2016 and used a second generation tank-style device, the Kangertech EVOD model with 18mg/ml nicotine. This is an older style device and more effective vaping products are now available.

Side-effects of the combined treatment were uncommon and improved with time and no serious harmful effects were caused by the treatment itself.

The study adds to the growing body of evidence that vaping helps smokers quit. A large randomised trial earlier this year found that vaping almost doubled the quit rate of nicotine patches and gum. After 12 months, 18% of smokers allocated to vaping had quit compared to 9.9% of those using a nicotine patch. This latest study shows that adding a nicotine patch to a vaping device with nicotine increases quit rates even further.

The authors point out that e-cigarettes combined with patches do not work for everyone, but should be offered as one of the many smoking cessation aids available. According to investigator Professor Chris Bullen:

“People using e-cigarettes should be encouraged to fully switch away from tobacco to e-cigarettes, with the aim of eventually also stopping vaping (if possible), given the lack of any long-term safety data for these devices.”

The trial was funded by the Health Research Council of New Zealand.

Study

Walker N et al. Nicotine patches used in combination with e-cigarettes (with and without nicotine) for smoking cessation: a pragmatic, randomised trial. Lancet Respir Med 2019

Posted by Colin Mendelsohn, colin@athra.org.au


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