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Research Shows E-Cigs Might Be As Good For Quitting As Nicotine Patches
"Taking a drag from an e-cigarette may be just as safe and effective as slapping on a nicotine patch for smokers struggling to quit, according to the first physician-run trial to compare the two products." That's according to research recently published in The Lancet (PDF) and reported by Bloomberg. Why is this significant? From the article: "If European and U.S. regulators treat e-cigarettes as medical devices, yet leave cigarettes on general sale, tobacco makers 'will retain their market monopoly, and we will never learn whether e-cigarettes would replace traditional cigarettes if allowed to continue evolving and competing with smoked tobacco on even terms,' [wrote clinical psychology professor Peter Hajek]. The results will also be presented today at the European Respiratory Society’s annual meeting in Barcelona.
E-cigarettes have taken Europe and the U.S. by storm. In France, there are more than 1 million regular users, according to a government-commissioned report published in May. Sales worldwide will probably approach $2 billion by the end of this year and top $10 billion by 2017, according to a forecast by Wells Fargo & Co."
yummy, I always like breathing in someone else's medicated ethylene glycol.
Some drink at the fountain of knowledge. Others just gargle.
Anecdotal evidence: Myself and many of my friends switched to ecigs with success. Many of us tried and failed with other methods. Now I have a roaring ecig addiction that tobacco just can't satisfy. So that's not quite a successful quit yet, but in terms of harm reduction it's looking good so far. Since I can control the strength of the liquid by mixing it myself, I'm working on a very long, gentle taper down.
Caffeine and nicotine got me through all nighters cramming for exams but quitting smoking was one of the hardest things I've ever done. It took me 9 years of trying and failing to quit to finally kick the habit. I think I just got too embarrassed to once again claim to be quitting. I don't know the neuroscience but caffeine and nicotine are powerful stimulants. I might go for E-cigs if there's no bad health side effects.
I quit using Swedish SNUS which broke the oral fixation/habit of puffing on a smoke while providing the nicotine my body craved. I tapered off using Swedish SNUS within six months, and while I still have cravings occasionally I haven't started smoking again. Please note I didn't use the American versions of SNUS, I ordered real "Swedish" brands that are imported. - HEX
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It seems you failed to grasp the notion of addiction.
bullshit, a real libertarian would say if someone wants to use something less dangerous to themselves and others to get their nicotine, let them pay for it, let companies sell it
The FDA is saying they will take control of e-cigarettes, one reason being that many under 18 are using them. Never mind that even 40+ years ago 12 year olds who wanted to smoke found ways of getting their illegal cigarettes
As someone who got into e-cigs relatively early (2009) and still vapes, it's important to note that they are NOT really meant for quitting. Sure, it's possible to quit using them, but they are more intended to be a replacement device. It's only quitting in the sense that you're not using traditional cigarettes anymore.
Why are they catching on?
1. They are (likely to be) healthier. Sure, some will say that e-cigs contain ingredients present in anti-freeze. These same ingredients, though, are also found in rescue inhalers, fog machines, and Twinkies. Mostly, though, they don't contain all of the tar and poisonous substances we all know are present in other cigarettes.
2. You don't smell like burnt paper, and don't make you smell like burnt paper for the rest of the day. Pretty self-explanatory.
3. (Or 2a) You can vape indoors, and stealth-vape. Smoking outdoors is fine eight months of the year here in Upstate NY. The other four months - and all of the days it's raining - having to go outdoors sucks. Not only in homes and apartments, but at bars. Also, if I'm in a place where I don't want people to know I vape, I can just go into the bathroom or a toilet stall, and nobody is the wiser. Not the same for a cigarette.
4. Much easier to maintain a constant buzz. I recently had the charger I've had since the start decide to stop working, so I switched back to traditional cigarettes. I absolutely hated that I felt like hell or got enough of a buzz to make my legs weak.
is that everyone insists they are 100% healthy, and have none of the problems of traditional cigarettes.
Just because they don't share the same issues as cigarettes doesn't mean they are completely healthy. We need to wait until studies are done.
Given that studies have shown risk associated with nicotine patches and harmful chemicals have been found in ecigs, I think I'll wait.
Also, screw all the people who exhale in public places because they think it's acceptable to bother people with vapor because it isn't smoke.
If you ignore ACs because they are anonymous - you're an idiot.
I've replaced my cigarrette addiction with alcoholism, it's been going great - from what I can remember.
All the studies on second hand effects I've read up on so far say there are none. I remember one that even said it would be safe around infants. As far as the smell, my vanilla blend has received second hand reviews from "indifferent" to "kind of nice smelling". Would you be ok with a bit of musty vanilla wafting by briefly (dissipates fast, no lingering nastiness)? How is it any different then from that old woman with the gallon of perfume?
I don't understand you objection to seeing them. I have to see all kinds of things I'm not a big fan of in public.
Too often I've seen people claim to have "quit using terrible analogies", which is like saying stopped driving a Ferrari and started eating porridge for breakfast.
I started smoking at age 20. Deliberately. Of my own volition. Primarily for the stimulant effect and secondarily to defy the goddamn anti-smoking meddlers... their disingenuous, logical fallacy-laden TV commercials really induced my rage.
I collected approximately nine pack-years of cigarette smoking.
I broke the nicotine physical addiction several times over those years (zero nicotine intake for 3+ weeks); however, what kept dragging me back to smoking was the fact that I mentally identified myself as a smoker. Smoking was part of my identity, which meant that cessation was always in dichotomous tension between "health" and "self". To put it in perspective, I likely self-identified more strongly with the term "smoker" than the term "American".
I quit my smoking habit permanently the day I had my first e-cig delivered in 2009. A few months later I tried a single cigarette, found the taste revolting, and haven't smoked since then. Smoking is unwieldy and a serious inconvenience during the winter (I never smoked inside my domicile). Downsides of quitting smoking included having my sense of taste/smell return... the world is revolting and ignorance is bliss.
Notwithstanding, after several years of "vaping" e-cigs inside our home no one has ever been able to tell—my life partner would tell me, because she hates the smell of cigarettes and always comments whenever we are near someone who recently smoked.
I have given e-cigs to all my smoker friends and relatives. All of these people have subsequently quit smoking (some of these smokers had been engaged in the habit for 30+ years). In fact, they all quit using nicotine altogether, leaving me as the sole remaining individual in my monkeysphere who cultivates a nicotine addiction.
E-Cigarettes aren't "as good as" the patch - they are much, much better. I smoked 1-2 packs a day for 28 years and was finally able to quit due to e-cigs. My lungs sound better, I feel better, and I don't stink anymore.
The patch left me with a rash on my arm.
Well, there's no smoke in an electronic cigarette. So who is using the "creative definition," the people saying they aren't smoking or you?
Even the big players no longer identify themselves as being in the "tobacco Industry".
They are now in the "Nicotine Delivery" business, one of the only non-controlled addictive drugs sold over the counter to anyone (of age) who wants it.
Dan. -- So what if it's spelt wrong, nobody's perfect
I just find it strange when people recharge them in the USB port of their laptop.
Congrats for finally doing it.
If it acquires resources on instantiation like a duck, then its a shared_ptr<Duck>
What studies? Something funded by the e-cig industry? By the tobacco companies looking to sell a new addictive product?
Big tobacco fought tooth and nail against the idea that second hand smoke is harmful. We already know nicotine is a addictive and has some negative health effects (birth defects).
Sorry, but I certainly don't want this crap in my lungs. There needs to be controls on where it can be used.
People who switch to e-cigs *have* quit smoking if you define smoking as inhaling the toxic brew of chemicals, tar, carbon monoxide, and nicotine resulting from burning tobacco leaves. They have not quit nicotine, of course, but that is a different issue. The vapor from e-cigs should be thought as steam containing nicotine. I have gone from about 1.5 packs of cigarettes a day to about 1.5 packs of cigarettes per week by using e-cigs to feed my nicotine addiction. E-cigs can be significantly cheaper than smoking tobacco, especially in places with high tobacco taxes.
I really shouldn't have used someone else's email address for this account.
It wasn't really my intention to stop smoking altogether I just found I didn't need to anymore.
Probably took about 3 or 4 months until I realised I could taste and smell better, they really do work although I think a lot depends on the quality of the liquid used.
I'd go as far to say that they have almost certainly extended my life and I couldn't have stopped without one.
How does the libertarian who doesn't want second hand nicotine react?
How does the libertarian who doesn't want second hand nicotine react?
Ask people not to smoke on his property?
Cigarettes and coffee is also known as the supermodel diet.
The cigarettes act as an appetite suppressant and the coffee as a stimulant.
No need for food... unless you want to live a long and healthy life that is.
Good thing you don't get any second hand smoke from ecigs.
Conclusions: For all byproducts measured, electronic cigarettes produce very small exposures relative to tobacco cigarettes. The study indicates no apparent risk to human health from e-cigarette emissions based on the compounds analyzed.
It's easy to find a bunch of "what if" that says it's harmful second hand. People that bother to test find levels so low (if at all) that it's not a problem.
I'll agree to your controls. They can't be used where scientific evidence shows they will harm others. Better get used to the smell.
“For more than 25 years Smokefree Pennsylvania has been advocating indoor smoking bans. Based on the results of this study I see no reason for e-cigarettes to be included in smoking bans.” - Bill Godshall of Smokefree Pennsylvania.
“Most vapers believe e-cigarette vapor is not harmful to those around them, but it is reassuring to finally have scientific evidence confirming those beliefs.”- Spike Babaian, President of National Vapers Club
This is the first study to cover such a wide range of toxins, however previous studies, which have evaluated a smaller number of toxins, have shown similar results.
“The results of this study confirm the findings of my last 4 years of research. E-cigarettes pose no discernible risk to public health." - Dr. Murray Laugesen - Public Health Medicine Specialist, Health New Zealand
source
"quitting", not quitting.
As I recall, nicotine patches are actively bad for quitting, compared with not using anything. What they perform better than is "placebo" patches which, of course, actually contain small amounts of nicotine. On the grounds that if they didn't you could smell the difference and they wouldn't be a proper placebo. The exact amount of nicotine is not disclosed, last I heard, but the interesting thing is that nicotine addiction appears to be highly responsive to even small amounts of nicotine getting in your system; it's only completely cutting it out that seems to actually help people shake the addiction. (That, and stuff like buproprion, which can short-circuit the addiction mechanism.)
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It appears you missed the point, what with the glaring 'libertarian' tags.
I don't read AC A human right
Um, ok. I missed it was supposed to be taken as an irony warning.
After 22 years of smoking up to 2 packs per day, increasingly bad health and high prices ... and many previous attempts to quit smoking, I used Chantix plus an e-cig.
Chantix alone was OK at first, but then I started cheating, grabbing a puff or a half cig. I quickly learned it was the physical habit of taking a drag from a cigarette that was really hitting me. I grabbed a low nicotine e-cig and used it for those cravings (zero nicotine wasn't available locally). An "equals two packs" e-cig lasted me 2 to 3 months and after 9 months I just stopped using that too.
I've been smoke free for 18 months now. And yes, I had the weird dreams with Chantix ... I liked them!
I understand that e-cigarettes may be able to be used to kick an addictive habit that has horrific health risks. However, it is another addictive pastime that probably has health risks of its own.
It has the potential of becoming a fad which would hook millions who believe it to be safe into a dangerous and expensive habit. Something the corporate powers would relish being that they consider this a real cash cow and anyone hooked a mere crop to be cultivated.
If I didnâ(TM)t have morals and I controlled an evil tobacco company I would endeavor to gain control of the e-cigarette market so that I could manipulate the price of both products. That way if tobacco sales started to fall off I could raise the price of e-cigarettes enough to drive customers to the more affordable tobacco products. Back and forth I would cultivate my crops.
The race isn't always to the swift... but that's the way to bet!
I tried that but managed to lose my wife, job, and house in the process... now I'm trying eCigs.
What studies? Something funded by the e-cig industry? By the tobacco companies looking to sell a new addictive product?
If you'll pay attention, you'll notice the big tobacco companies didn't start the e-cig market and only lately started getting involved (in traditional big business style, by buying up established players.)
They don't want you buying an e-cig where there's a clear migration path from the small, cigarette-imitating models with disposable cartomizers to larger, fill-once-vape-all-day models, and from there to mixing your own nicotine juice at home, which will be cheaper, and include none of the addiction-enhancing additives they can cram in cigarettes (and, presumably, could cram in their own, expensive juice). The only reason they're getting involved at all is because it's clear that cigarettes are going to be largely replaced by e-cigs over the next several decades, and they want a foothold when that happens.
I tried the patch. Repeatedly. The patch did nothing for me but give me trippy dreams. A side effect of getting far too much nicotine. Meanwhile, my desire to smoke only increased.
The problem with the patch is it's barking up the wrong tree. It'd be perfect for fighting smoking through nicotine addiction. But nicotine addiction isn't an actual problem.
The nonsense about nicotine and addiction is overblown. I'm sure there are exceptions, but in my experience, it's about as addictive as caffeine. No, there's two real addiction issues that keep people puffing:
- Formaldehyde, arsenic, and thirteen other carcinogenic herbs and spices, brought to you by everybody's favorite dark-type Pokemon, Altria. Ever wonder why they put so much horrible shit into cigarettes? Yeah. This is a company, among other companies, in an entire industry dedicated to designing a product people will be addicted to even if it kills them.
- General fixation. I don't think non-smokers appreciate how goddamned awesome it is to have something to do with your hands, to have an excuse to socialize, to exhale huge clouds of smoke/vapor like yer a freakin' dragon or something.
You can't deal with the first problem through anything other than sheer force of will, unfortunately. Now, if it was nicotine that caused addiction, everyone would slap on the patch and be done with it. If it was simply nicotine, you could largely ignore oral/etc. fixation - you wouldn't have the many, many, many sad tales of people who tried and failed to switch to e-cigs.
They *HAVE* quit smoking. They are no longer inhaling smoke. They are also not inhaling tars, ash particulates, carbon monoxide or any of the hundreds of non-nicotine alkaloids in tobacco.
They just haven't stopped using nicotine.
Interestingly, the vast majority (possibly all) of harms attributed to nicotine are actually from the most common delivery method or other constituents of tobacco and have nothing to do with the nicotine itself.
However, the study in TFA was quite clear that they were looking at cessation of nicotine consumption.
The two clinical trials on ecigs in 2013 have been conducted using 3.3V batteries that resemble the appearance of tobacco cigarettes. These deveices are often refferred to "cigalikes". Four major Big Tobacco companies have invested in the electronic cigarettes with the automatic function. The patent for this technology is owned by the orginal makers of electronic cigarettes, Ruyan. The automatic function uses piezoelectronic sensor, and Ruyan has been successful in defending it's patents. Blu Cig had to had to settle with Ruyan prior to being purchased by Lorrilard. You can be sure that RJR's Vuse, BAT's Vype and Phillip Morris' MarkTen have or will have to go through similar licencing of the technology. Recently, Imperial Tobacco have considered buying Ruyan's patent.
However, the major threat to Big Tobacco (and ecig companies specialising in 1st generation cigalike devices such as NJOY and E-lites), are the second generation electronic cigarettes.
A review of this recent clinical study even made a point about this: http://tobaccounpacked.wordpress.com/2013/09/08/e-cigarettes-versus-nicotine-patches/
"one issue to be clear on is that the results of the study only really applies to the brand that was tested (which was a fairly low-performance and basic e-cigarette model). E-cigarettes take many different forms and improvements in technology are rapid. If a higher performance ‘second generation’ device that provided better nicotine delivery or better consumer experience were used, results could be different. Hopefully following this study, others will design research looking at this."
Most second generation electronic cigarettes have the simple button click function, variable voltage/wattage, functioning, far longer charge time, and come with refillable tank systems. An example is the eGo model, orginally designed and patented by Janty, but through Chinese manufacturing, the eGo has been copied, rebranded numerous times, and has now essentially become a generic name for one of the most popular electronic cigarette devices. They look nothing like a real cigarette, and so these products will always have a defence against the extremist anti-smoking group claims that electronic cigarettes undermine efforts to denormalise tobacco smoking. The products offer much more to vapers over the 3.3V cigalikes that Big Tobacco have been investing in, and most long term vapers will recall their initial and 'single' purchase of a cigalike device as a mere introduction to vaping, before quickly moving to 2nd generation devices and refillable tank systems.
Even if Big Tobacco decide to start gobbling up companies that specialise in 2nd generation electronic cigarettes, it wont be hard for people to simply redesign a battery, have it maufactured in China, and sell them in competition with whatever Big Tobacco are trying to flog. Basically, Big Tobacco's days are very much numbered.
The only way Big Tobacco will survive is if Bad policy prevails, such as regulating ecigs and nicotine liquids as "medicines", which would raise the barrier to market entry into the millions of dollars, ensuring that only Big Tobacco and Big Pharma can afford to enter the market and acquire sale authorisations. Unfortunately, in the US and EU, polticians who are easily persuaded by Big Pharma and Big Tobacco lobby groups are more than happy to bow to their special interests.
The nicotine market is very messy right now.
With cigarettes you know that they're not good for you and the companies have an absolutely enormous list of ingredients they can add to them to increase how quickly your body takes in the nicotiene and keep you addicted, and they're not required to tell you what nasties they added.
But each death stick from the same subset of a brand will all have the same level of nasties in them, whereas e-cig liquid can vary from batch-to-batch as it's not regulated.
Although saying that I did once buy a pack and the first stick made me feel like I was smoking ten at once, I threw it away because suspected it was fake and I didn't want to go back to the shop and say "hey these cigarettes I bought from you are killing me"
Maybe it's time I went tech on my nicotiene intake...
To do something right, you often have to roll up your sleeves and get busy.
I recently quit smoking cigarettes and switched to an e-cigarette.
The first day was hell and felt exactly like quitting smoking cold turkey. The second day however, I was surprised to find I felt completely fine.
I use my e-cigarette with roughly the same frequency as I used to smoke cigarettes. I even go to the smoking room at work (I live in a country that still has "smoking rooms" at work) to use it, despite that I could use it at my desk. That way, I get the same feeling of having 'had a break' from sitting at my desk that I used to get with cigarettes.
There are some common misunderstandings about smoking/tobacco/nicotine, so I'd like to mention a few here.
1) Nicotine is the only addictive substance in tobacco: false. Nicotine itself is moderately addictive, but nowhere near as addictive as cigarette smoking when consumed without the rest of the tobacco product. The main reason for this is that tobacco also contains a monoamine oxidase inhibitor (MAOI) - a type of drug that is commonly used as an antidepressant. This on its own is moderately addictive as well, but combined with nicotine becomes extremely addictive. One of the main withdrawal symptoms for smokers who have smoked a long time is depression, and it seems clear from the limited research so far that this is caused by the MAOI withdrawal more than the nicotine withdrawal (which is mostly things like the sore muscles and constipation).
2) Nicotine is highly poisonous: false. Tobacco is pretty poisonous. Nicotine itself is a drug that may have some negative effects in very high doses, but at the levels used by smokers (and e-cigarette smokers), the nicotine really doesn't cause much harm at all, if any. Research shows the negative effects of very high doses, but is fairly inconclusive on moderate doses, with most research pointing towards no harmful effect.
3) e-Cigarettes create smoke, so are just as bad as cigarettes: false. e-Cigarettes create a vapour - essentially steam - that contains ethylene glycol, flavour, and often (but not always) nicotine. It looks (and feels) This vapour does not coat the lungs in tar, which is one of the main dangerous effects of cigarette smoking. As a note, you can you e-cigarettes near a smoke detector and it won't go off, so on long flights, even if the cabin staff aren't okay with you using it, you can do so in the toilet and no-one will be any the wiser.
Overall, I'm very happy with my e-cigarette. I do plan on quitting it as well in around a year's time (because the e-cig is still quite antisocial, and still costs money), but as a "stepping stone", it's definitely been the best choice for me and I'm starting to feel the improved health effects already.
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+1
I really, really welcome them.
I frankly don't care if you want to kill yourself, now or over time with smoking. But you are poisoning the same air I am breathing and that bothers me. And anything that can solve that is fantastic.
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Isn't weird how the most ardent anti cigarette advocates are actually on the same side as big tobacco?
I think e-cigarettes *could* be as good as nicotine patches for smoking cessation *if* they were promoted and regulated in the same way. But they're not. At least not yet. I expect most countries will crack down on them in due course.
You could just stop buying cigarettes, sticking them in your face and setting fire to them. I quite smoking (when I had reached the point of craving a cigarette while actually smoking one) by asking myself a few questions: do you really want to give your consent and your money to an industry that slaughters its own customers in their millions? do you want to do something so evidently disgusting and stupid as paying a predatory corporation to poison you? do you want to look like an idiot? would you smoke if cigarettes had arsenic in them (nicotine is about 4x as poisonous)? who's in charge here? A tip for those who want to quit: choose a moment of maximum stress – first day back at work, middle of divorce, moving house.... The -– mild – distress from nicotine withdrawal gets lost in the noise.
Science fiction for grown-ups...
Thanks for pointing that out, I'm not yet familiar with all the new features of HTML5.
For some reason the headline on here is the wrong way round. The study actually found that ecigarettes were more effective than nicotine patches, but the study lacked statistical power to determine whether they were significantly more effective or not.
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Eh, it's somewhat more of a strawman warning, actually. I'm actually a libertarian and don't hold the stated views 100%.
I at least acknowledge that tobacco is freaking addictive and it's tough to quit. My major sympathies lie with the ones who start smoking in 'the good old days' when the companies were running ads about the health benefits of smoking, doctor endorsements, etc... I might be a libertarian, but that doesn't mean that you're allowed to be deceptive.
I don't read AC A human right
I quit after 34 years. I used the patch. I seen a few try and fail using the patch but they all had 1 thing in common they felt good enough that they started cutting the patch thats a nono do not cut the patches or you will fail. My doc said it and its stated on the instructions so dont cut the patches I was given a prescription for the strongest patch and had to go twice as long with them before going to a smaller dosage. I will say i do get urges now and then its mental for sure i mean i smoked for 34 years and enjoyed it.
Jack of all trades,master of none
Most of the people I know that smoke have switched to e-Cigs, not to quit, but because its not as disgusting as using traditional cigarettes. I know someone that decided to start smoking specifically because he found e-Cigs was not as hard on his lungs as a regular cigarette.
I don't think these things were created to stop smoking, they were created as a modern 21st century way to get your tobacco fix in a way that doesn't make you smell like a stale ashtray, which might actually cause smoking to increase again which will bring more profit to the tobacco industry.
I haven't thought of anything clever to put here, but then again most of you haven't either.
I can't tell if you're joking, or if you're an idiot. Pot isn't addictive, and nicotine is, so you're calling the wrong group drug addicts.
You cause so much harm to a good cause by being a crazy motherfucker who is stuck on cold turkey rather than solutions that eliminate all the external problems and most of the internal ones.
Once the second hand smoke is gone (whether or not it causes cancer, it causes side-effects), it's no longer any of your business what people do to themselves. And once the carcinogens like tar are gone, e-cigs are really much better health-wise for the smoker than cigarettes.
It's like a fat person said they stopped eating only straight-up butter and switched to eating salad with a reasonable amount of light dressing, and you castigating them for not switching to a raw lettuce and water diet.
Aside from the fact that you never run out as long as you have a big bottle of juice and a couple charged batteries, you aren't inhaling thousands of carcinogenic combustion products with every puff.
The constituents of the juice are glycerine, propylene glycol (not the same as antifreeze), nicotine, and flavoring. The only unknowns really come from the flavoring but you can readily read their ingredients. E-cig flavorings are typically non-oil-based food grade flavors.
If you smoke, I encourage you to try this. Just get a disposable if you want to see what its like without investing a lot. Also, if you do decide to get a real setup, don't get one that looks like a cigarette, they are obsolete, get a bigger model with a larger or replaceable battery.
Clickety Click
I don't see sucking on an e-cig to be different from smoking, especially not in a good way. We are supposed to breathe clean air. The anti-tobacco insanity that hammers the message that NOTHING is worse than tobacco smoking has brought us e-cigs. Smokers think they are safe, and suck away on those e-cigs. They have so much approval, as opposed to the abuse endured as a tobacco smoker. Strange that social conditioning utterly cancels out the ability to think, to our great peril. I guess we'll find out how much time it will take an e-smoker to suffer from breathing in unnatural substances. We already know that toxic tobacco smoking can take half a century to show its toxicity to the smoker.
e-cigarettes are not for smoking cessation. The smoker who uses them has not quit the behavior, just which substances are being inhaled. Because nothing is worse than tobacco, e-cigs must be safe, and since they are tasty and smell pleasant, former outdoor smokers can use them inside and much more often/continuously. Scary.
I used patches for four months and failed to quit. The nic cravings decreased but I still wanted to reach out for a cig every now and then. Recently i started "vaping" e-cigs and i feel that these would be a better alternative compared to patches/gums. Still, i'd like to know the long term effects on the lungs and heart, but until then I'm just happy i was able to quit my ciggies. Patches seem reliable since they're FDA-approved and all, but the success rates seem inflated and the cost is much higher compared to e-cigs (according to this article: http://ecigarettereviewed.com/nicotine-patches-and-gums-vs-electronic-cigarettes). I guess if you're concerned about the side effects of e-cigs, you're better off with patches - but that won't really guarantee you'll quit smoking.