Not enough evidence that e-cigarettes help to stop smoking, surgeon general says

The surgeon general's report is the first in 30 years to focus entirely on quitting tobacco.

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By Rosemary Guerguerian, M.D.

E-cigarettes are often promoted as a tool to help smokers quit, but there’s still not enough scientific evidence to back up this claim. There is evidence, however, that many young people are introduced to tobacco through e-cigarettes.

Surgeon General Jerome Adams cited that earlier evidence on Thursday, when he spoke about the 2020 Surgeon General report on tobacco. This year’s report — the 34th overall — was the first in three decades to address smoking cessation specifically.

The report comes in the midst of a heated debate about flavored e-cigarettes, which public health officials say hook kids. In early January, the Food and Drug Administration announced a ban on nearly all flavored e-cigarette products, except for menthol and tobacco-flavored pods.

At a news conference Thursday, Adams urged people to focus on what the research has shown about e-cigarettes.

A lot of the available studies on whether e-cigarettes can help people quit tobacco, however, involve specific products, so these findings can’t be applied to e-cigarettes as a whole, Adams said, adding that many of the products that were studied have since changed, and that there are countless others on the market.

While the research is ultimately insufficient to draw conclusions about whether e-cigarettes are an effective tool for quitting, Adams said that he encourages companies to submit applications to the FDA for e-cigarettes as a cessation aid.

Indeed, most people who smoke — some 70 percent — want to quit, according to the report, and more than half of smokers try to do so each year.

Many of these smokers, however, are not taking advantage of the available tools to help.

Adams recommended several approaches that have been proven to help people quit. FDA-approved medications, combined with behavioral counseling, doubles the success rate of quitting. Support for quitting is also available through text message and internet-based services.

The report reiterated the benefits of quitting tobacco: Doing so can add 10 years to your life, drastically reduces the risk of heart disease, lung disease and 12 types of cancer, and reduces harmful effects on fertility and pregnancy. Smoking accounts for 1 in 5 deaths in America, and remains the largest preventable cause of death, disease and disability in the country, the report said. Thirty-four million Americans smoke cigarettes.

CORRECTION (Jan. 23, 2020, 10:03 p.m. ET): A previous version of this article misinterpreted, in the headline and first paragraph, a statement by the surgeon general on the link between e-cigarette and tobacco use. He said many young people begin using tobacco through e-cigarette use, not that the use of e-cigarettes leads people to start smoking. It also misinterpreted the surgeon general about maintaining access to e-cigarettes for adult smokers who want to quit. He was referring to companies maintaining access to an FDA regulatory pathway, not access in general.

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