A major new study finds that people who smoke switch to safer heated tobacco products altogether after gaining access to them – even if they have no intention of quitting, or have experienced past challenges in doing so, according to news reports April 20.
The first-of-its-kind study, called CEASEFIRE, recruited 220 participants. They were an average of 41 years old and smoked one pack of cigarettes per day. They had an average of two attempts to quit smoking.
Participants were randomly divided into two groups: one was given refillable e-cigarettes and the other was given a heated tobacco product – a device that heats a tobacco stick to produce vapor, without burning to produce smoke. Researchers sought to compare the effectiveness and tolerability of the two harm-reduction options.
High rates of smoking cessation and abstinence were observed in both groups, which one researcher described as significant.
Understanding the key role of taste in making the switch, they also provided participants with a choice of three different flavors. In addition, motivational counseling was provided throughout the 12-week study.
Quit rates were high in both groups, 39.1% with heated tobacco products ( IQOS 2.4 Plus) and 30.8% with e-cigarettes ( JustFog Q16).
The results for both combustion-free devices were encouraging – the difference between the two rates was not considered significant – and it is worth noting that more than 95 percent of participants completed the study.
“The data confirm the effectiveness and tolerability of e-cigarettes, as well as the health potential of heated tobacco products for smokers who do not intend to quit.” said lead researcher Maria Signorelli.
Both e-cigarettes and heated tobacco products are safer than combustible cigarettes, which kill more than 7 million people worldwide each year.
Some participants even became healthier during the short-term study period.
“We observed an increase in exercise tolerance in participants compared to initial levels,” he said. We observed an increase in participants’ exercise tolerance compared to initial levels,” said Pasquale Caponnetto, another researcher. “From the first month, many patients reported that they breathed better and felt less fatigue during small but important daily activities such as climbing stairs or doing housework.”
In Italy, where the study was conducted, heated tobacco products have been sold for years in tabaccheria (tobacco stores) and, along with cigarettes, in vending machines. Japan, where such products are also popular, has seen an unprecedented decline in cigarette sales in just a few years. This is an action to reduce the harm of tobacco.
In 2020, the U.S. Food and Drug Administration authorized IQOS to market it on the basis of reduced exposure to harmful chemicals compared to cigarettes. But a patent dispute delayed the launch in the United States.
Different things work for different people, and both e-cigarettes and heated tobacco products are important tools for reducing smoking rates.
Researchers from the Department of Clinical and Experimental Medicine and the Center of Excellence at the University of Catania conducted a study comparing the effectiveness, tolerability and acceptability of heated tobacco products and refillable e-cigarette replacement cigarettes (CEASEFIRE): a randomized controlled trial for accelerated harm reduction (CoEHAR).
Unfortunately, this study excluded individuals with a mental health diagnosis or a history of problematic substance use other than tobacco. These two groups had the highest rates of smoking, smoking-related illness and premature death. Their inclusion in studies of safer nicotine products is critical.
Researchers caution that longer follow-up studies are needed to confirm significant and long-term smoking cessation and whether the results can be generalized to settings that do not provide high levels of support.
However, the CEASEFIRE study suggests that giving smokers, even those who do not intend to quit, the option of heated tobacco products or e-cigarettes can be very effective. Different approaches work for different people, and both are important tools for reducing smoking rates.