Smokers who switched to e-cigarettes were much more likely to quit than people who used nicotine patches, gum or similar products, according to a large study.

The bad news: People who successfully quit tobacco were often hooked on e-cigarettes.

E-cigarettes are considered far less hazardous than the ones you light up. Still, American health officials worry about their addictive nature and lure for young people. But British health officials tend to look more favorably upon them.

"We know that there are millions of smokers out there who successfully stopped smoking by switching to vaping," says Peter Hajek, a public health researcher at Queen Mary University of London. But doctors who want to recommend a way to stop smoking want to base that decision on a randomized study.

So Hajek and his colleagues enrolled nearly 900 people who wanted to quit smoking in a test. Half randomly got e-cigarettes. The other half got traditional treatment: nicotine patches plus gum, lozenges, nicotine inhalers or whatever kind of oral nicotine they preferred.

"The e-cigarettes were significantly more effective than nicotine replacement treatment," Hajek says.

As he and his colleagues report Wednesday in the New England Journal of Medicine online, about 10 percent of people with standard treatment quit smoking for at least a year, while 18 percent of the people given e-cigarettes had quit.

"The figure may sound low, but these type of clients would, if they were quitting on their own, the quit rate would be about 3 percent," Hayek says.

People who use vaping to quit smoking have milder cravings, he says. They also get pleasure from the act of vaping, which may contribute to its success as a tobacco-quitting aid. And over time, many people gradually reduce the dose of nicotine they are receiving through these devices, Hajek says, so that makes it easier for people who want to quit vaping.

In his view, if the technology can more easily wean people away from the much more hazardous act of tobacco smoking, that's a good thing.

American health officials and scientists are generally much more leery about vaping, especially among young people. Nicotine use can affect brain development and other ingredients of e-cigarettes aren't t benign.Vaping has rapidly increased among high-school students and young adults.

"The good news is that traditional smoking has gone down in these populations," says Belinda Borrelli, a psychologist and professor at Boston University's Henry M. Goldman School of Dental Medicine, who co-wrote an editorial Wednesday on e-cigarettes and smoking cessation in the New England Journal of Medicine. "But the question is, if we have many adults using e-cigarettes, are we going to renormalize the addiction, essentially."

She says people who vape to help them stop smoking should at least have a plan to get off the e-cigarettes afterward: "E-cigarettes shouldn't be thought of as a lifelong commitment."

Hajek says it's true that many people do keep vaping, but he says that at least it's easier to quit vaping than smoking. Vaping doesn't solve the problem of nicotine addiction, but its risks are considered lower those of tobacco use.

"It would be very similar to drinking coffee," he says. "You have a lot of people who have to have their cup of coffee every day. They do it because there's stimulant drug in it, and it's very similar to using pure nicotine without the toxins, which actually kill people. So from our point of view, on this side of the pond, this is not a public health issue any more."

But it very much remains one in the United States.

You can contact NPR Science Correspondent Richard Harris at[email protected].

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