Benefits of e-cigarettes in smoking reduction and in pulmonary health among chronic smokers undergoing a lung cancer screening program at 6 months

Lucchiari, Claudio; Masiero, Marianna; Mazzocco, Ketti; Veronesi, Giulia; Maisonneuve, Patrick; Jemos, Costantino; Salè, Emanuela Omodeo; Spina, Stefania; Bertolotti, Raffaella; Pravettoni, Gabriella

doi:10.1016/j.addbeh.2019.106222

Cited by 53 publications

(120 citation statements)

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“…In a study recruiting smokers from an Italian screening program for lung cancer and including clinic-based follow-up and telephone smoking cessation counselling, Lucchiari et al found 19.0% of 70 smokers randomised to three months of ENDS and 10.0% of 70 smokers randomised to control achieved continuous biochemically verified abstinence at six month follow-up (RR 1.86; 95% CI 0.79- 4.38). 31…”

Section: Resultsmentioning

confidence: 99%

“…Nor did it change substantively when the random-effects meta-analysis was restricted to studies with no noted potential competing interests (RR 1.80; 95%CI 0.81-3.99; I 2 = 0.0%), although evidence was even more limited, with 24 of 208 participants ceasing smoking (Supplementary Figure S1). Two of the included studies were assessed as having a high risk of bias 29,30 and one was found to have some concerns 31 (Supplementary Table S3).…”

Section: Resultsmentioning

confidence: 99%

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Systematic review and meta-analysis of evidence on the efficacy of e-cigarette use for sustained smoking and nicotine cessation

Banks

Yazidjoglou

Brown

et al. 2020

Preprint

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Objective: To systematically review and meta-analyse evidence regarding the efficacy of electronic nicotine delivery systems (ENDS) as smoking cessation aids. Data Sources: PubMed, Scopus, Web of Science, PsycINFO, MEDLINE and Cochrane Library were searched up to February-March 2020 (PROSPERO registration CRD42020170692). Study selection: Published peer-reviewed randomised controlled trials (RCTs) of the efficacy of ENDS for sustained cessation of combustible tobacco smoking and/or nicotine use, compared with no intervention, placebo or nicotine replacement therapy (NRT) by intention-to-treat, with a minimum of four months follow-up. Data Extraction: Data were extracted independently into a pre-specified template. Risk of bias was assessed with the Cochrane Collaboration′s tool and evidence quality rated using GRADE. Data Synthesis: From 3,973 titles identified, nine RCTs were identified; 330 of 5,445 smokers randomised quit. Smoking cessation did not differ significantly for randomisation to ENDS versus: no intervention (three studies, random-effects meta-analysis RR 1.95; 95%CI 0.90-4.22); placebo (three studies, 1.61; 0.93-2.78) or NRT (three studies; 1.25; 0.74-2.11). Fixed-effects sensitivity analyses showed significant results for ENDS vs NRT (1.43; 1.10-1.86). Smokers randomised to ENDS were substantially more likely than control to use nicotine at follow-up. Overall evidence quality was low. Considering only studies without potential competing interests further limited evidence but did not materially change conclusions. Conclusions: There is insufficient evidence that ENDS are efficacious for smoking cessation compared to no intervention, placebo or NRT. Results are promising, particularly for therapeutic use, but vary according to analytic method. ENDS may lead to greater ongoing nicotine exposure than other smoking cessation methods.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Systematic review and meta-analysis of evidence on the efficacy of e-cigarette use for sustained smoking and nicotine cessation

Banks

Yazidjoglou

Brown

et al. 2020

Preprint

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“…associated with significantly increased smoking cessation in randomized clinical trials of e-cigarettes as smoking cessation therapy. Nine RCTs [16][17][18][19][73][74][75][76][77] were included for analysis. In 7 of the 9…”

Section: Provision Of Free E-cigarettes Wasmentioning

confidence: 99%

“…RCTs, the control group was provided free cessation aids 16,17,19,73,74,76,77 ; 2 RCTs provided the control group with smoking cessation counseling only. 18,75 In Figure 4 and Table 2).…”

Section: Provision Of Free E-cigarettes Wasmentioning

confidence: 99%

“…When determining whether a new tobacco product is appropriate for the protection of the public health, TCA §910(c)(4) requires FDA to consider the risks and benefits to the population as a whole including users and nonusers of the tobacco product, and taking into account (A) the increased or decreased likelihood that existing users of tobacco products will stop using such products; and (B) the increased or decreased likelihood that those who do not use tobacco products will start using such products. 77 Halpern et al 16 Hajek et al 73 Lee et al 76 Lucchiari et al 18 Walker et al 19 Hatsukami et al 74 Holliday et al 75 Bullen et al 17 Lee et al 77 Halpern et al 16 Hajek et al 73 Lee et al 76 Lucchiari et al 18 Walker et al 19 Hatsukami et al 74 Holliday et al 75 Bullen et al 17 1 extent that people who smoke simply add e-cigarettes to their cigarette smoking (becoming so-called dual users), their risk of heart disease, [80][81][82][83] lung disease, 84,85 and cancer 86 disease, [80][81][82][83]92 lung disease, 84,85,93,94 and cancer. 86,95,96 By contrast, the RCTs suggest that however, also requires that they be "safe," meaning that the benefit-to-risk ratio must be favorable.…”

Section: Implications For Fda Regulation Of E-cigarettesmentioning

confidence: 99%

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E-Cigarette Use and Adult Cigarette Smoking Cessation: A Meta-Analysis

2021

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Objectives. To determine the association between e-cigarette use and smoking cessation. Methods. We searched PubMed, Web of Science Core Collection, and EMBASE and computed the association of e-cigarette use with quitting cigarettes using random effects meta-analyses. Results. We identified 64 papers (55 observational studies and 9 randomized clinical trials [RCTs]). In observational studies of all adult smokers (odds ratio [OR] = 0.947; 95% confidence interval [CI] = 0.772, 1.160) and smokers motivated to quit smoking (OR = 0.851; 95% CI = 0.684, 1.057), e-cigarette consumer product use was not associated with quitting. Daily e-cigarette use was associated with more quitting (OR = 1.529; 95% CI = 1.158, 2.019) and less-than-daily use was associated with less quitting (OR = 0.514; 95% CI = 0.402, 0.665). The RCTs that compared quitting among smokers who were provided e-cigarettes to smokers with conventional therapy found e-cigarette use was associated with more quitting (relative risk = 1.555; 95% CI = 1.173, 2.061). Conclusions. As consumer products, in observational studies, e-cigarettes were not associated with increased smoking cessation in the adult population. In RCTs, provision of free e-cigarettes as a therapeutic intervention was associated with increased smoking cessation. Public Health Implications. E-cigarettes should not be approved as consumer products but may warrant consideration as a prescription therapy.

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Electronic cigarettes for smoking cessation

Hartmann‐Boyce

McRobbie

Butler

et al. 2021

Cochrane Database of Systematic Reviews

154

102

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BackgroundElectronic cigarettes (ECs) are electronic devices that heat a liquid into an aerosol for inhalation. The liquid usually comprises propylene glycol and glycerol, with or without nicotine and flavours, and stored in disposable or refillable cartridges or a reservoir. Since ECs appeared on the market in 2006 there has been a steady growth in sales. Smokers report using ECs to reduce risks of smoking, but some healthcare organizations, tobacco control advocacy groups and policy makers have been reluctant to encourage smokers to switch to ECs, citing lack of evidence of efficacy and safety. Smokers, healthcare providers and regulators are interested to know if these devices can help smokers quit and if they are safe to use for this purpose. This review is an update of a review first published in 2014. ObjectivesTo evaluate the safety and effect of using ECs to help people who smoke achieve long-term smoking abstinence. Search methodsWe searched the Cochrane Tobacco Addiction Group's Specialized Register, the Cochrane Central Register of Controlled Trials (CEN-TRAL), MEDLINE, Embase, and PsycINFO for relevant records from 2004 to January 2016, together with reference checking and contact with study authors. Selection criteriaWe included randomized controlled trials (RCTs) in which current smokers (motivated or unmotivated to quit) were randomized to EC or a control condition, and which measured abstinence rates at six months or longer. As the field of EC research is new, we also included cohort follow-up studies with at least six months follow-up. We included randomized cross-over trials, RCTs and cohort follow-up studies that included at least one week of EC use for assessment of adverse events (AEs). Data collection and analysisWe followed standard Cochrane methods for screening and data extraction. Our main outcome measure was abstinence from smoking after at least six months follow-up, and we used the most rigorous definition available (continuous, biochemically validated, longest follow-up). We used a fixed-effect Mantel-Haenszel model to calculate the risk ratio (RR) with a 95% confidence interval (CI) for each study, and where appropriate we pooled data from these studies in meta-analyses.

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Benefits of e-cigarettes in smoking reduction and in pulmonary health among chronic smokers undergoing a lung cancer screening program at 6 months

Cited by 53 publications

References 37 publications

Systematic review and meta-analysis of evidence on the efficacy of e-cigarette use for sustained smoking and nicotine cessation

Systematic review and meta-analysis of evidence on the efficacy of e-cigarette use for sustained smoking and nicotine cessation

E-Cigarette Use and Adult Cigarette Smoking Cessation: A Meta-Analysis

Electronic cigarettes for smoking cessation

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