Nicorette may be losing business due to rising e-cig use.

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Traditional smoking cessation devices may be losing business to e-cigarettes. Getty Images

If you’re confused about whether e-cigarettes will actually help you quit smoking, there’s a good reason for that.

As a novel technology, the scientific evidence for e-cigarettes as an aid to quit smoking is mixed. Some studies have reported that e-cigarettes are effective at helping to quit, while others disagree.

“Most studies show that these products have not demonstrated effectiveness in quitting. Many individuals who use e-cigarettes also continue to smoke. In fact, use of the e-cigarettes can interfere with individual’s commitment to stopping their tobacco use,” said Patricia Folan, RN, DNP, director for the Center for Tobacco Control at Northwell Health in Great Neck, New York.

The Food and Drug Administration (FDA) hasn’t approved any e-cigarette or vaping device as a “smoking cessation” device, which requires special approval and review by the FDA to ensure that the product is both safe and effective.

Nonetheless, during his tenure, former FDA Commissioner Dr. Scott Gottlieb expressed on numerous occasions his belief that e-cigarettes have the potential to help adult smokers quit.

But that message has largely been overshadowed by a truly disturbing surge in tobacco use among youth, driven by e-cigarettes.

Gottlieb has bluntly called e-cigarette use among American youth an epidemic.

E-cigarette companies have also been accused by public health organizations, including the American Lung Association (ALA), of falsely marketing their products as smoking cessation devices, despite the fact that the FDA hasn’t approved them as such.

This month, the ALA and other signatories, including the American Academy of Pediatrics and American Heart Association, issued a letter to acting FDA Commissioner Dr. Norman E. Sharpless, urging him to investigate e-cigarette company Juul for falsely marketing their products as a means of helping users quit smoking.

The letter argues that Juul’s “Make the Switch” campaign, which encourages smokers to switch from traditional cigarettes to e-cigarettes, “communicates the message that by switching to JUUL, the smoker can achieve what he/she had previously been unable to achieve: quitting smoking. It is, unmistakably, a smoking cessation claim.”

FDA-approved cessation devices exist, but they don’t appear to have the appeal or novelty of e-cigarettes. Nicotine patches, lozenges, and gums are FDA approved and available over the counter in most drugstores.

Nicotine replacement therapy (NRT) is a recognized and effective means of smoking cessation by public health organizations, including the American Cancer Society and ALA.

Studies have shown that NRT can double the chances of quitting smoking.

But the NRT marketplace has remained static over the years, with little innovation.

Nicorette recently debuted its first new product in 10 years, a coated ice-mint nicotine lozenge designed with a better flavor and texture. The coating provides both a hit of minty flavor and helps give the lozenge a smoother texture.

A common complaint about nicotine lozenges is that they can be chalky with an unappealing nicotine taste.

GlaxoSmithKline, the parent company of Nicorette, has even brought on a major spokesperson, NASCAR legend Dale Earnhardt Jr., a former smoker, to lead the new “Taste Test Drive” campaign.

Scott Yacovino, brand director of Nicorette and NicoDerm at GSK Consumer Healthcare, told Healthline in an email that there’s a “lack of clarity” around the safety of e-cigarettes.

“At Nicorette we’re always evaluating how we can continuously improve our products to better meet our consumer needs and help them along their quit journey,” Yacovino said in the email to Healthline. “Our new Nicorette Coated Ice Mint Lozenge is designed to taste great — it’s the first-ever FDA-approved coated lozenge — and deliver long-lasting craving relief, working even after the lozenge dissolves. We’re excited to provide smokers with a new tool to use on their quit journey.”

Folan said having new products can be helpful for people looking to quit smoking.

“I think having some new and different products that are also safe is a step in the right direction. Innovation that is attractive to the public may provide motivation to quit. Changing the formulation of the lozenge (making it less chalky and more palatable) may entice smokers to use the product,” said Folan.

Nicorette’s sales have been inconsistent in recent years. A widespread theory is that smokers are turning to e-cigarettes to help them quit, even though they still lack consistent scientific evidence and FDA approval as smoking cessation devices.

The enormous selection of e-cigarette flavors, which range from traditional tobacco to fruits and even ice cream, is recognized as one of the most appealing elements for individuals trying to quit, but also for youth.

Because flavors appear to attract both kids and adults alike, the FDA has waffled over how it intends to regulate flavored tobacco products and prevent them from getting into the hands of minors, while still keeping them available for adult users.

“The e-cigarettes and vaping products are apparently more attractive to consumers [due to] the flavors, the large variety,” said Folan.

Despite some burgeoning evidence that e-cigarettes may help smokers quit traditional cigarettes, many profound questions remain on the potential harmful effects that e-cigarettes could have, particularly among youth.

A big concern for health experts has been the rise of e-cigarette use among teens. Early nicotine exposure as a teen dramatically increases the risk of a long-term nicotine addiction.

Earlier this year the American Academy of Pediatrics called for stricter regulations around e-cigarettes after 21 percent of high school students reported using an e-cigarette device in the prior month.

“E-cigarettes need stronger federal regulations to prevent youth access and use,” Dr. Susan C. Walley, FAAP, co-author of the statement and chair of the AAP Section on Tobacco Control, said in a statement. “The research is clear that teens are at higher risk of transitioning to traditional cigarettes even with experimental use of e-cigarettes.”

In a letter to the editor of the Washington Post, Dr. Albert Rizzo, chief medical officer of the ALA, wrote, “The American Lung Association cannot support e-cigarettes as a way to quit smoking… The characterization of e-cigarettes as the silver bullet for helping smokers quit is not a reality. Meanwhile, the FDA’s failure to curb marketing to children is leading to another generation of nicotine addicts.”