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E-cigarettes: an evidence update <br /> <br />46 <br />and medication (NRT on prescription or Champix), the problem is that few smokers <br />access these services, limiting their impact on population health. <br /> <br />This section reviews the evidence regarding the use of EC for stopping smoking that <br />has been published since the Cochrane Review [39] on the use of EC for smoking <br />cessation and reduction (cutting down). The Cochrane Review is briefly summarised <br />below. <br /> <br />Figure 14: Support used in quit attempts <br /> <br />From: smokinginengland.info/latest-statistics <br /> <br />Randomised controlled trials <br />To date, two randomised controlled trials (RCTs) have tested the efficacy of EC for <br />stopping smoking, one among smokers wanting to stop and the other among smokers <br />not intending to quit within the next month [40, 41]. Both were among highly dependent <br />smokers. A recent Cochrane Review of these RCTs [39] concluded that they <br />demonstrated that EC with nicotine help smokers reduce their cigarette consumption <br />and stop smoking compared with no nicotine EC (placebo). However, the authors <br />cautioned that there was uncertainty in the findings, and gave their findings a ‘low’ <br />confidence rating using GRADE standards. The Cochrane Review also considered <br />observational studies of EC use and cessation. They concluded that these <br />observational studies were generally consistent with the findings of RCTs. Since the <br />Cochrane Review, one RCT[41], and a secondary analysis of one of the RCTs in the <br />Cochrane Review[42] have been published and are discussed below.