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You may be using the wrong e-cigarette type to quit smoking

If you're puffing on an e-cigarette to quit smoking, the type of device you use may make a difference.

Almost 28 percent of people who used refillable "tank" models every day to get their nicotine hit gave up smoking, compared with 11 percent of those using "cigalikes" that are disposable or use replaceable cartridges, according to a study by addiction scientists at King's College London. Quitting rates for non-daily users of e-cigarettes were lower, though tank aficionados still came out ahead.

The findings, published in the journal Nicotine & Tobacco Research, may be significant for smokers trying to decide which type of e-cigarette to try. Tanks may deliver nicotine more effectively, and the devices allow users to adjust nicotine content and flavors, which along with price may be factors that lead to more success in quitting, the researchers said.

"Our research demonstrates the importance of distinguishing between different types of e-cigarettes and frequency of use when examining the association between e- cigarettes and quitting," Sara Hitchman, a lecturer in the King's Institute of Psychiatry, Psychology and Neuroscience who led the study, said in a statement.

The research comes amid debate about the safety of the devices, the potential need for regulation and whether e- cigarettes may encourage people to start using the real thing. California health officials have expressed alarm that many young people are using e-cigarettes and may end up smoking as a result.

Heart Association

E-cigarettes deliver nicotine without the tar and many of the harmful chemicals found in traditional cigarettes, though there is disagreement about whether some harmful chemicals are still present in their vapor. The American Heart Association has said physicians shouldn't discourage e-cigarette use as a last resort for smokers seeking to quit.

The U.S. Food and Drug Administration proposed e-cigarette regulations a year ago that would ban sales to minors, prohibit free samples, require agency review and mandate addiction warnings. The FDA hasn't yet finalized the rules.

In the U.K., e-cigarettes will be licensed as medicines by next year, along with other products such as nicotine gum and patches, under rules approved in 2013. More than 2 million people in Great Britain use e-cigarettes, among a population of about 64 million, according to the researchers.

The findings also may have implications for cigarette makers. Many of the most popular cigalike brands are produced by the tobacco industry, and most of the e-cigarette users in the study were using that type of device, the researchers said.

Tobacco Role

In the U.S., Lorillard Inc., Reynolds American Inc. and Altria Group Inc. are among tobacco companies that market both tobacco cigarettes and e-cigarettes. British American Tobacco Plc is developing nicotine inhalers, and Imperial Tobacco Group Plc is buying the Blu e-cigarette brand in a purchase related to Reynolds' takeover of Lorillard.

Disposable and cartridge-loaded e-cigarettes represented 57 percent of the U.S. "vaping" market last year, according to Reynolds American, though liquid-refill tank models are gaining rapidly.

"It is important to remember that these products are not actually sold as quitting aids; they are simply an alternative," Will Hill, a spokesman for British American Tobacco, said by email.

Hybrid Models

"Our focus remains on providing a wide variety of high- quality alternative products" ranging from cigalikes to hybrid models that allow users to adjust the amount of vapor released, Hill said. BAT also makes cigarette brands such as Lucky Strike and Pall Mall.

While Fontem Ventures, a subsidiary of Imperial Tobacco, has only offered cigalikes to consumers, it will introduce a tank version starting with the French market "very soon," spokesman Marc Michelsen said by phone. The company can't make claims on smoking cessation as the products aren't licensed as medical devices, he said.

"We are working to develop a range of products that can be both satisfying and potentially reduced-risk alternatives to combustible cigarettes," Philip Morris International Inc., which sells both cigalike and tank e-cigarettes, said in an e- mailed statement.

With the tank devices, which are often sold in specialty "vape" stores, users buy liquid refills with different strengths of nicotine. They can choose traditional tobacco flavors or more exotic varieties with names such as "Apple Strudel" and "Café Latte." The King's researchers said they were aware of only one refillable tank model made by a tobacco company in the U.K.

In the study, the researchers analyzed 1,643 adult smokers and e-cigarette users over one year.

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