Vaping as good as Chantix to help quit smoking: JAMA study. Really!

Count me skeptical! Is vaping really an improvement over smoking? 

The study was conducted in northern Finland of all places. Maybe the Sámi peoples (laplander) are a little different from the average European and American citizen. Unfortunately, the study abstract is silent about the background of the participants. Possibly, a minority indigenous population were used as guinea pigs?

How relevant is a comparison with the smoking cessation aid like Chantix? Who paid for the study?

"E-cigarettes were about as effective at helping people quit smoking as the gold-standard pharmaceutical drug, varenicline, according to a clinical trial published Monday in JAMA Internal Medicine. ..."

From the key points and abstract:

"Key Points

Question

What is the relative effectiveness of nicotine-containing electronic cigarettes (ECs) and varenicline as smoking cessation aids?

Findings

In this randomized, double-blinded, double-dummy, placebo-controlled trial that included 458 adults with moderate to heavy dependence on nicotine who were motivated to quit smoking traditional cigarettes, nicotine-containing ECs and varenicline were both effective in helping participants to stop smoking for up to 6 months.

Meaning

The results of this randomized clinical trial indicated that nicotine-containing ECs seem to be an effective option as smoking cessation treatment for adults who smoke traditional cigarettes.

Abstract

Importance

Little is known about the relative effectiveness of nicotine-containing electronic cigarettes (ECs) compared with varenicline as smoking cessation aids.

Objective

To determine the relative effectiveness of ECs in smoking cessation.

Design, Setting, and Participants

This randomized placebo-controlled single-center trial was conducted in northern Finland. Participants aged 25 to 75 years who smoked daily and had volunteered to quit smoking were recruited from August 1, 2018, to February 20, 2020, via local media. The trial included 52 weeks of follow-up. All data analyses were conducted from September 1, 2022, to January 15, 2024. The participants, study nurses, and researchers were masked to group assignment.

Intervention

The participants were assigned by block randomization to receive 18 mg/mL of nicotine-containing ECs together with placebo tablets, varenicline with standard dosing together with nicotine-free ECs, or placebo tablets together with nicotine-free ECs, all combined with a motivational interview, with the intervention phase lasting for 12 weeks.

Main Outcome and Measure

The primary outcome was self-reported 7-day conventional cigarette smoking abstinence as confirmed by the exhaled carbon monoxide level on week 26. The analysis followed the intent-to-treat principle.

Results

Of the 561 recruited participants, 458 (81.6%) eligible participants (257 women [56%]; 201 men [44%]; mean [SD] age, 51 [11.6] years) were randomized. The primary outcome occurred in 61 of 152 participants (40.4%) in the EC group, 67 of 153 (43.8%) in the varenicline group, and 30 of 153 (19.7%) in the placebo group (P < .001). In the pairwise comparison, placebo differed statistically significantly from ECs (risk difference [RD], 20.7%; 95% CI, 10.4-30.4; P < .001) and varenicline (RD, 24.1%; 95% CI, 13.7-33.7; P < .001), but the difference was statistically insignificant between ECs and varenicline (RD, 3.4%; 95% CI, −7.6 to 14.3; P = .56). No serious adverse events were reported.

Conclusions 

This randomized clinical trial found that varenicline and nicotine-containing ECs were both effective in helping individuals in quitting smoking conventional cigarettes for up to 6 months."

Vaping as good as Chantix to help quit smoking: JAMA study | STAT

Electronic Cigarettes vs Varenicline for Smoking Cessation in Adults A Randomized Clinical Trial (no public access)

Graphical abstract