Despite their popularity, outcome trials for the efficacy of electronic cigarettes (eCIGs) — as well as long-term safety/efficacy data — are insufficient. The public, voting with their wallet, have widely endorsed eCIGs, if the fact that more than one-quarter of persons attempting to quit smoking in the United Kingdom in 2013 reported trying eCIGs is an adequate reflection of public sentiment.

Bullen et all performed a trial in New Zealand of adults expressing a wish to stop smoking (n = 657). Study subjects were randomized to an eCIG, placebo eCIG, or nicotine patch. Telephone counseling was available for additional support PRN. Smoking status (confirmed by exhaled carbon monoxide testing) was ascertained 12 weeks after the quit day.

 Quit rates were low in all three arms of the study: 7.3% (eCIG), 4.1% (placebo eCIG), and 5.8% (nicotine patch). Because the quit rates were substantially lower than anticipated in the power calculation of the study, it was not possible to discern whether there was a statistically significant difference between the quit rates on “real” vs placebo eCIGs. In any case, the difference between them would hardly appear to be clinically relevant. There were no differences shown in serious adverse events, but considering the fact that eCIG use may potentially span many years, it would be premature to conclude that long-term use of eCIGs is safe.