Quitting smoking is one of the best things you can do for your health, but it's also one of the most difficult. There are myriad smoking cessation products available, from the patch to medications and beyond, but one of the most overlooked may be the e-cigarette. While most people consider it to simply be a replacement for traditional cigarettes, experts say that when used correctly, e-cigarettes may be a powerful tool to help you quit.
"E-cigarettes are less addictive and have fewer carcinogens than a traditional cigarette," says Rima Gidwani, a pulmonologist at the University of Texas Health Science Center in Houston. "There's definitely a role for e-cigarettes in smoking cessation."
E-cigarettes are battery-powered devices that vaporize liquid, often containing nicotine and other flavorings, such as bubble gum, mint or chocolate. Studies on the subject are slim, but new research published earlier this week out of the University College London found that e-cigarettes were 60 percent more effective at helping people quit when compared to quitting cold turkey. The 60 percent might be a little overblown since most people don't try and quit cold turkey, Gidwani says, but nevertheless, the number is promising. "If we did a study here in the United States, we'd likely see e-cigarettes to be very effective."
[Read: How Do I Quit Smoking?]
Despite a lack of studies, the anecdotal evidence is there, says Carla Berg, an assistant professor of behavioral sciences and health education at Emory University's Rollins School of Public Health in Atlanta, who has seen patients successfully quit with e-cigarettes. "They're very attractive to smokers," she says. "Besides the nicotine, e-cigarettes also allow smokers to have the hand-to-mouth motion that has become such a habit with them."
The studies that are available, Berg says, are favorable toward e-cigarettes. "They show promise for e-cigarettes for helping people quit," she says, "especially when they haven't been able to with other products."
The key to using an e-cigarette to quit is to gradually wean yourself off nicotine by moving to lower and lower doses, Berg says. However, using an e-cigarette is an inexact science, especially since they are not regulated by the Food and Drug Administration. A lack of FDA regulation means there can be vast disparities between the amount of nicotine advertised on the packaging and the amount the liquid actually contains. The FDA recently proposed a new rule that would allow the agency to regulate e-cigarettes, but that is still under consideration.
"One of the big concerns is that often times, first-time users get a very high level of nicotine because they don't realize how much is in the liquid they use," she says. "The flavoring can also cover up the taste of the nicotine, so when they first take a puff, the amount of nicotine can make them very jittery and cause them to discontinue use."
If you're using an e-cigarette to help you quit, Berg advises that you start with a low nicotine concentration. "Be conservative when you're starting out," she says. "Look for something advertised as 12 mg/mL or less, and increase if you really feel the need to. But for most people, that's the best starting point."
It's also important you don't try to quit alone. "We like to add on group therapy and doctor intervention to teach people how to cope with cravings," she says. "And for people who are heavy smokers, we add on an aid like a drug, patch or gum." In Gidwani's experience, e-cigarettes are most effective when you combine them with other smoking cessation methods.
Adding the e-cigarette component for heavy smokers might be the push they need to finally kick the habit, Gidwani says. "If you think of an e-cigarette as behavioral therapy and add it on to the patch or gum, you'll get much better numbers [of people quitting] than just using the e-cigarette alone."
Although the anecdotal evidence seems to show e-cigarettes to be effective, the issue, Gidwani says, is that with the lack of quality studies, it's hard to know whether people who quit using this method actually quit for good -- partly because of how new they are. Though the first smokeless cigarette was patented in 1963, it wasn't until 2003 that e-cigarettes as we now know them made it to market. "In the U.S., the percent of people who quit and stay away from cigarettes one year after they quit is 35 percent and at five years 20 percent," Gidwani says. "So while evidence points to e-cigarettes helping people quit, we don't know for sure if these people are long-term quitters."
But even proponents of the devices, like Derek Yach -- the former head of tobacco control for the World Health Organization -- are sometimes wary of their effects. While e-cigarettes show promise for helping smokers quit, Yach says, the lack of evidence concerning long-term effects can make them difficult to recommend, especially if you compare them to the low-tar, low-nicotine cigarette boom in the 1960s. "Low-tar and low-nicotine cigarettes were billed as a healthier alternative to cigarettes, just like e-cigarettes," he says. "But people who used them ended up having very high rates of lung cancer. We don't want to get caught in recommending something that ends up being dangerous again."
Experts also worry that e-cigarettes could normalize smoking for the younger generation. "These products can draw people who may not otherwise have started smoking," Yach says.
[Read: Your Kid Smokes. Now What?]
However, Gidwani says that until studies show e-cigarettes to be dangerous, she'll continue to recommend them. "Cigarettes are deadly," she says. "The full verdict isn't in on e-cigarettes, but we know they're better than traditional ones."