The use of e-cigarettes as a smoking cessation tool across the European Union tripled between 2012 and 2017, according to a report published this week by Tobacco Control in the British Medical Journal (BMJ).

Research into smoking cessation across 27 EU member states was carried out by asking current and former smokers a series of questions. Data was collected on national smoking cessation policies from the Tobacco Control Scale (TCS), which scores European countries according to their tobacco control policies. All member states were part of the study except Croatia, which joined the EU in 2013 when the research was already underway.

The results show that in some parts of Europe, those who tried to quit in the past five years have become more inclined to transition to e-cigarettes instead of options like pharmacotherapy (Nicotine Replacement Therapy) and cessation services.

The use of e-cigarettes for smoking cessation assistance increased from 3.7% to 9.7%, the use of pharmacotherapy decreased from 14.6% to 11.1% and smoking cessation services suffered a decline from 7.5% to 5%.

In some EU countries, e-cigarettes were found to be two and three times more useful than cessation assistance and in these states, current and former smokers were shown to be less likely to go down the pharmacotherapy or health professional route.

“The reported use of e-cigarettes as cessation assistance was almost two times higher in countries with low TCS treatment score in the 2017 wave and much higher in countries with medium and high TCS treatment scores.”

It has also been established that young people between 15 and 24 are more likely than those over 55 to have used any cessation assistance including e-cigarettes, but this demographic were less likely to have received advice from health professionals or cessation advice.

The report concludes:

“This highlights the need to evaluate their [e-cigarettes] efficacy and impact on individual abstinence as well as their population-level implications and to explore whether they may be displacing standard cessation assistance. These findings highlight the need for approaches that ensure that smokers get support to quit smoking across the EU. The question of whether the availability of e-cigarettes will displace other methods, and the impact of such a displacement, should be closely evaluated.”

Overall, the majority of respondents had tried to quit without assistance.

Tobacco treatment specialist and Associate Professor in the School of Public Health and Community Medicine at the University of New South Wales has responded to the report on social media.

This research comes about as the World Health Organisation has selected a 30% reduction in tobacco use as one of the 25 by 2025 goals, and the WHO European office has professed their
ultimate goal to have a smoke-free Europe. Now we know that e-cigarettes are proving their worth and taking the lead where smokers wishing to quit for good are concerned.

Smoking levels and tobacco controls vary from one member state to the next and as a result, there is also a difference in stop-smoking services and tools EU-wide. The report says,

“This variation in provision of cessation assistance has raised concerns over how people are attempting to quit, especially if they are unable to access evidence-based smoking cessation methods.”

The research was funded by the European Commission and was collected and compiled by academic authors at Imperial College London, the University of Athens, the German Cancer Research Center, Heidelberg and the Smoking Cessation Service of Madrid. 

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