E-Cigarettes Unhelpful in Smoking Cessation Among Cancer Patients

“In a new study of cancer patients who smoke, those using e-cigarettes (in addition to traditional cigarettes) were more nicotine dependent and equally or less likely to have quit smoking traditional cigarettes than non-users. Published early online in Cancer, a peer-reviewed journal of the American Cancer Society, the findings raise doubts about the potential benefits of e-cigarettes for helping cancer patients give up smoking.

“Because of the risks of persistent smoking, all cancer patients who smoke should be advised to quit. But the rising use of e-cigarettes has raised many questions among patients and their health care providers including whether e-cigarette use helps or hinders quitting efforts. Even regulators are struggling with the complexities associated with e-cigarettes as they weigh the benefits and risks to the general population and subgroups of individuals.

“To examine available clinical data about e-cigarette use and cessation among cancer patients, Jamie Ostroff, PhD, of the Memorial Sloan Kettering Cancer Center in New York City, and her colleagues studied 1074 cancer patients who smoked and were enrolled between 2012 and 2013 in a tobacco treatment program within a comprehensive cancer center.

“The researchers observed a three-fold increase in e-cigarette use from 2012 to 2013 (10.6 percent versus 38.5 percent). At enrollment, e-cigarette users were more nicotine dependent than non-users, had more prior quit attempts, and were more likely to be diagnosed with lung or head and neck cancers. At follow-up, e-cigarette users were just as likely as non-users to be smoking. Seven day abstinence rates were 44.4 percent versus 43.1 percent for e-cigarette users and non-users, respectively (excluding patients who were lost to follow-up).”

E-Cigarette Vapor Promotes Cancer-Like Transformations of Airway Cells with Predisposing Mutations

E-cigarettes (electronic cigarettes that use a battery-powered system to deliver nicotine without producing smoke) are advertised as a safer alternative to tobacco cigarettes. However, very few studies have investigated how e-cigarettes affect lung function and lung cancer risk. Researchers examined human airway cells with mutations in the TP53 and KRAS genes, which are often mutated in the airways of current or former smokers at high risk of lung cancer. When the cells were exposed to e-cigarette vapor, they developed cancer-cell-like behaviors and gene expression changes very similar to what was seen when these cells were exposed to tobacco smoke. E-cigarettes may increase the risk of developing lung cancer in high-risk people, including current and former tobacco smokers.