USPSTF issues final recommendation on smoking cessation in adults

There isn’t enough evidence yet to say whether e-cigarettes are safe or effective for helping people quit smoking, new US guidelines on tobacco cessation conclude.

“Smoking cessation is tough, but clinicians and patients have a variety of evidence-based interventions to choose from”, task force member Francisco Garcia, MD, MPH, said in the release. One of the trials found no difference in cessation rates between those who used nicotine patches, e-cigarettes with nicotine and e-cigarettes without nicotine.

US Preventive Services Task Force (USPSTF) is a government-backed independent organization that reviews medical evidence in support of tobacco cessation guidelines so they can determine if insurance can pay for certain screenings and treatments.

The USPSTF recommends that clinicians ask about tobacco use, advise adults to stop using tobacco, and provide behavioral interventions and pharmacotherapy for smoking cessation (grade A recommendation).

Are e-cigarettes less harmful or just as bad and smoking tobacco?

Research Director at ScotCen Social Research Diarmid Campbell-Jack said: “These findings confirm that e-cigarettes are being used by a small, but not insignificant proportion of people in Scotland with one in every twenty saying that they now use electric cigarettes”.

It is strongly encouraged that clinicians advise adults to use a combination of both – personal and cessation medication – interventions.

“The task force recommends that clinicians direct patients who smoke tobacco to other cessation interventions with established effectiveness and safety”, Garcia said by email. The final recommendations are published online in Annals of Internal Medicine and on the task force’s web site.

Sheila Duffy, Chief Executive of health charity Action on Smoking and Health (ASH) Scotland said: “It’s encouraging that the majority of adults who smoke in Scotland want to quit and for some, e-cigarettes seem to be an acceptable alternative to smoking, or a way of quitting cigarettes”.

Furthermore, lead study author Carrie Patnode comments, “There is a large variation in the devices and cartridge fluids publicly available and new products are rapidly entering the market”. It is clear that more data on both the benefits and harms of these products-from well-designed trials-is needed.