Mayo Investigates possible medical value for e-cigarettes

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By COREY NOLES

A recently released study conducted by Mayo Clinic in Rochester, Minnesota, has found positive results among patients using e-cigarettes instead of traditional cigarettes following surgery.

The study, published January 31, 2016, in Nicotine & Tobacco Research, was trying to determine the feasibility of using electronic nicotine delivery systems (ENDS) to help patients lower the risk of postoperative complications. It cites cigarette smoking as a known factor for an increased risk of such complications.

All of the 67 individuals involved in the study were smoking adults scheduled for elective surgery between December 2014 and June 2015. Each was given a supply of ENDS to use prior to and for two weeks following surgery. The patients’ use of the devices was recorded and compared with their normal smoking behavior.

At the 30-day follow-up appointment, 51 percent planned to continue using the devices with their average daily cigarette intake falling from 15.6 per person to 7.6. A total of 17 percent reported that they had completely ceased smoking cigarettes.

Dr, Brian Carter, member of the Consumer Advocates for Smoke-free Alternatives Association (CASAA) Board of Directors and the organization’s scientific communications director, said that while the study’s focus was quite narrow, its addressing an issue that has plagued surgeons for years.

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Carter, who is a former faculty member in the Department of Behavioral Science at the University of Texas M. D. Anderson Cancer Center, said that surgeons will not typically operate on cancer patients as long as they continue smoking because of the additional risks that are created.

“It’s just kind of a given the smoking slows the healing process,” Carter said. “If doctors can find a value in using electronic cigarettes as a means of harm reduction before and after operations, that could be of value throughout the profession.”

He cautioned that more research would still need to be done, given that the focus of this study was only on elective surgery. Surgeons with Mayo seem to agree.

The results intrigued Mayo doctors enough that they encourage further exploration of ENDS as a means of helping surgical patients reduce, or possibly eliminate, cigarette consumption around the time of an operation.

The doctors added in the study that the devices were “well-accepted in surgical patients, and worthy of exploration as a harm reduction strategy” in such patients.

Being a feasibility study, the goal was essentially to determine if there was potential value in further, more long-term research on the subject – which they found to be the case.

“It’s interesting that (Mayo surgeons) are investigating this issue, because that means they acknowledge what’s found in e-cigarettes to be far different from what is found in combustible cigarettes,” Carter said. “The people in the surgical department must already recognize this or they wouldn’t have decided to investigate it.”

He cautioned that the feasibility study is a very preliminary part of the process. Feasibility studies are typically conducted to determine whether there is justification for further investigation. The data recorded can then be used to help apply for grants or other means to fund the study.

Carter said Mayo could take its continued research in several directions, but suggested that a larger, more broad study could determine what level of reduction in smoking is desired and achievable. Whether e-cigarettes could help make that goal attainable, is of particular interest to Carter.

“The next step is to determine what does this actually do in terms of promoting healing in post-operative patients,” he said. “Data of those patients using electronic cigarettes would then be compared with individuals smoking, as well as those who do not smoke or vape.”

Carter suggested a larger trial could be performed to establish what sort of reduction in cigarette smoking is desired and achievable; also can e-cigarettes reach that goal?

No information was shared regarding what devices were used by the patients. It is, however, implied that they were not allowed to select their own devices, which is one of the factors that is believed to play a role in the success of e-cigarette use as a smoking cessation device.

Carter explained that using a standard device with similar settings and nicotine levels would be necessary to follow established research measures.

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