Do Electronic Cigarettes Have a Role in Tobacco Cessation?

Abstract

Tobacco use continues to be a major cause of morbidity and mortality. Even with behavioral and pharmacologic treatment, long-term tobacco cessation rates are low. Electronic nicotine delivery systems, commonly referred to as electronic cigarettes or e-cigarettes, are increasingly used for tobacco cessation. Because e-cigarettes are widely used in this setting, health care professionals need to know if they are safe and effective. The purpose of this article is to review literature regarding use of e-cigarettes as a tool for tobacco cessation in patients who are ready to quit, as well as those who are not ready to quit, along with some selected patient populations. The safety and clinical implications of e-cigarette use are also reviewed. Small, short-term studies assessing smokers' use of e-cigarettes suggest that e-cigarettes may be well tolerated and modestly effective in achieving abstinence. High-quality studies are lacking to support e-cigarettes use for cessation in patients with mental health issues. One small prospective cohort study concluded that patients with mental health issues reduced cigarette use with e-cigarette use. Although one study found that patients with cancer reported using e-cigarettes as a tobacco-cessation strategy, e-cigarettes were not effective in supporting abstinence 6 and 12 months later. Additional research is needed to evaluate the use of e-cigarettes for smoking cessation in patients with pulmonary diseases. No data exist to describe the efficacy of e-cigarettes for smoking cessation in pregnant women. Although study subjects report minimal adverse effects with e-cigarettes and the incidence of adverse effects decreases over time, long-term safety data are lacking. Health care providers should assess e-cigarette use in their patients as part of the tobacco cessation process.

Effects of electronic cigarette aerosol exposure on oral and systemic health

“…E-cigarettes were shown as a source of third-hand exposure to nicotine that was recovered from windows, walls, floor, wood and metals [ 46 ]. Exposure to these residues can cause DNA damage and increase the risk for short-term and long-term health problems, including asthma and cancer [ [47] , [48] , [49] ].…”

Smoking Cessation and Vaping Cessation Attempts among Cigarette Smokers and E-Cigarette Users in Central and Eastern Europe

“…Between 2012 and 2017 the proportion of current tobacco smokers in the EU who had ever tried to quit tobacco smoking using e-cigarettes increased from 7.1% to 15.6% respectively [5]. However, there is a scientific debate around whether e-cigarette use is effective as a tobacco smoking cessation method [17,[20][21][22]. In addition to this, there are few studies investigating the cessation of vaping, with inconsistent results [23][24][25][26][27].…”

Electronic Cigarettes and Asthma: What Do We Know So Far?

“…This is particularly concerning since dual use seems to be the most common form of EC use [ 61 ]. Finally, three reviews that investigated the effectiveness of EC as a tool for smoking cessation in different groups of patients stated that the evidence on the use of EC as potential cessation tool is inconclusive, as few studies have been able to demonstrate an impact of EC use on harm reduction related to combustible cigarettes, which however does not address nicotine addiction, and that additional research was needed for patients with pulmonary diseases, including asthma [ 61 , 64 , 122 ]. Current evidence is inconclusive to recommend ECs as effective or safe smoking-cessation tools [ 123 , 124 ].…”