In the Harm Reduction Journal, Joksic et al. report their results from a randomised, placebo-controlled, double-blind trial in which 158 smokers were given snus and 161 smokers were given a placebo. Smoking status was verified throughout with carbon monoxide tests and 81% of participants enrolled because they wanted to quit smoking.
The results show that the snus-users were three times more likely to reduce their cigarette consumption by more than 75% and were two to three times more likely to quit smoking entirely.
An interesting feature of the study is that it was conducted in Serbia, which has no history of snus use. It is sometimes said that snus is a quintessentially Swedish habit that could never take off in the rest of the world. This seems to me a rather odd and slightly xenophobic view (see Alan Blum's quote in The Art of Suppression!) but this success in Eastern Europe shows that the 'Swedish experience' can indeed be exported.
The e-cigarette trial had a smaller sample (of 40) and no control, but if its results are replicated elsewhere, things look very encouraging. At the end of the six months, 22.5% of participants had given up smoking entirely. Amongst all participants, average cigarette consumption fell from 25 a day to 5 a day. As Michael Siegel says, this compares very favourably with pharmaceutical nicotine products. The special point of interest in this study is that none of the participants expressed any particular desire to quit smoking at the outset.
You might think the anti-smoking movement would be jumping for joy at the prospect of having two effective smoking-cessation products to offer the public. As I write this, ASH Wales is holding a conference in Cardiff (with the temperance lobby, natch). It would be nice to think that they are celebrating the news that there are efficacious nicotine products to compete with Big Pharma's 'nicotine replacement therapies', but somehow I don't think they will be.
I wonder why?
A lot of people are going to treat the Swedish Match snus study (Serbia) as "better" because it looks more like a typical medical therapy study, and are going to try to dismiss Riccardo Polosa's study (e-cigs) as not having the "proper" controls and whatnot. But Riccardo's study is actually much more impressive because it involves a reasonably natural situation: non-quitting smokers who simply have an e-cig pushed on them with some positive advice about it. That is much closer to how THR will actually happen.
ReplyDeleteAs I liveblogged from the SRNT meetings last month, the session where Riccardo presented this, and I and two others also talked about e-cigs was extremely popular. It was the only session that was SRO with people spilling out the door. Undoubtedly some of them were there because they hated the idea, but I think most of them (mostly honest scientists, not ASH-types) were willing to recognize the positive reality.
Propaganda might work on the weak of mind,but not on us hardcore smokers!
ReplyDeleteThey can take their laws and shove it
I aint following it no more!
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