E-cigarettes are almost twice as effective at helping smokers quit as nicotine replacement therapies such as lozenges and patches, according to a new study that immediately stoked the debate over whether e-cigarettes are an important smoking-cessation tool or a health menace.

The study, published online Wednesday by the New England Journal of Medicine, is the first randomized trial to test the effectiveness of modern e-cigarettes vs. nicotine-replacement products, said Peter Hajek, a psychologist at Queen Mary University of London, who led the trial. The researchers found that 18 percent of the e-cigarette users were smoke-free after a year, compared with 9.9 percent of those in the nicotine-replacement group.

Physicians have been reluctant to recommend e-cigarettes because of a lack of clinical trial data, Hajek said. ‘‘This is now likely to change,’’ he added.

But an editorial in the same publication threw some cold water on the trial’s results. Boston University researchers said e-cigarettes should be used only when Food and Drug Administration-approved treatments don’t work. Those therapies, as well as drugs such as bupropion, have higher effectiveness rates than the new study suggested, and much more is known about their side effects, said Belinda Borrelli, a BU researcher who cowrote the editorial. She noted that e-cigarettes pose some serious risks.

washington post