ACC House Call: E-Cigarettes for Smoking Cessation


Breaking down the details of the E3 trial, and what more needs to be found in the follow-up.

What is the best-case outcome of a lifetime smoker switching to electronic cigarettes?

In some ways, the randomized controlled trial comparing nicotine, non-nicotine, and cessation counseling—presented virtually at the ACC.20 Together with Word Congress of Cardiology (ACC/WCC) Scientific Sessions this week—is seeking to answer that question in the short-term and long-term.

The study results, presented by author Mark J. Eisenberg, MD, MPH, a cardiologist at Jewish General and professor of Medicine at McGill University, showed either nicotine or non-nicotine e-cigarettes plus counseling were associated with significantly greater likelihood of user combustible cigarette cessation than just smoking cessation counseling over 12 weeks.

That said, the research duration was hindered by manufacturing issues, and investigators intend to continue data collection for 1 year, with a final follow-up planned for September.

As Martha Gulati, MD, MS, noted, a 12-week cessation strategy is not a permanent fix—and there’s little to no consideration given to the health of switching cigarettes for vaping products.

“I think we’ll be really interested in the one-year data,” Gulati said. “But the other question it leaves for us is, what’s in them? I don’t know how much nicotine is in them, I don’t know what other carcinogens in them. But I do know nicotine is in them, and therefore, it is addictive like cigarettes.”

In an interview with HCPLive®, Gulati, a cardiologist at Banner — University Medicine Heart Institute, and chief of Cardiology at the University of Arizona, explained the shortcomings of the 12-week trial results while also emphasizing the need for expanded research into e-cigarette products.

Gulati also discussed the strategies and processes that go into helping a patient quit smoking for the sake of their cardiovascular health.

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