With Smoking Cessation Help Like This, Who Needs Obstacles? New Study Shows Dismal Effectiveness of Web-Based Cessation Intervention

A new study published online ahead of print in the journal Addiction reports that a web-based smoking cessation intervention, similar to those which have become standard of care in the United States, was dismally effective in achieving smoking cessation.

See: Mason D, Gilbert H, Sutton S. Effectiveness of web-based tailored smoking cessation advice reports (iQuit): a randomised trial. Addiction 2012. doi: 10.1111/j.1360-0443.2012.03972.x.

In the study, 1758 visitors to the QUIT web site who were adult smokers living in the UK were randomized to one of two web-based smoking cessation interventions. One included tailored smoking cessation advice based on individual attitudes, beliefs, and behavior, and the other provided web-based materials without tailored content.

The primary outcome was 3-month sustained abstinence at 6-month follow-up. The tailored advice group had a six-month cessation rate of 9.3%. The non-tailored advice group had a cessation rate of 9.3%.

The Rest of the Story

This intervention, which represents a typical smoking cessation intervention that forms the basis for tobacco control funding in the United States, had a dismal success rate of less than 10%. Combined with yesterday's story which reported long-term quit rates of only about 8% with nicotine replacement therapy and Chantix, these data should help readers realize that the "state-of-the-art," "evidence-based" smoking cessation strategies that currently are recommended by most anti-smoking organizations and government agencies have a failure rate of upwards of 90%.

Given these findings, it is inexcusable that anti-smoking groups and some researchers are advising ex-smokers who have quit smoking using electronic cigarettes (or who are considering trying to quit using electronic cigarettes) to instead use "approved" cessation strategies. It is inexcusable that the World Health Organization continues to view electronic cigarettes as an "illegitimate" smoking cessation strategy, given that the "legitimate" cessation strategies fail more than 90% of the time.

We have to do better than this and I believe that we can. However, we are being held up. What is holding us up is not technology, but instead, ideology. The technology is now here. We have the ability to deliver nicotine in a relatively clean form using a device which simulates smoking and addresses both the pharmacological and behavioral aspects of smoking addiction. What is missing. I believe, is the will to pursue such a strategy.

That will is missing, I believe, because anti-smoking groups are adhering to an ideology which holds that anything that looks like smoking is evil and cannot possibly be condoned, even if it greatly improves the public's health. The fact that electronic cigarette use looks like cigarette smoking is precisely the factor that makes it so effective in helping many smokers to stay off cigarettes. Yet that is precisely the factor which makes the strategy so distasteful to anti-smoking groups.

If there were effective existing approaches to smoking cessation, then I would agree that promoting electronic cigarettes would not make any sense at this stage, since we do not know exactly how effective they are. However, since we know that existing strategies are unlikely to work, and we also know that thousands of smokers are having success with electronic cigarettes, I do not see how we can continue to promote the "approved," "legitimate" smoking cessation methods over the innovative approach of a non-tobacco, no-smoke cigarette that delivers relatively clean nicotine.