E-cigarettes and nicotine abstinence: a meta-analysis of randomised controlled trials

Abstract

ObjectivesTo determine the effects of electronic cigarettes (e-cigarettes) as a therapeutic intervention compared to nicotine replacement therapy (NRT) on nicotine abstinence.MethodsTwo authors independently searched the PubMed, Embase, PsycInfo and Cochrane Central Register of Controlled Trials databases for articles published up to and including 10 July 2021. We included randomised controlled trials (RCTs) in which nicotine e-cigarettes were compared to NRT among current cigarette users. The primary outcome was abstaining from all nicotine-delivery devices. Secondary outcomes were 1) allocated product use (e-cigarettes or NRT) among successful cigarette quitters and 2) quitting cigarettes at the end of the trial using fixed-effect Mantel–Haenszel models.ResultsWe included four RCTs representing 1598 adult participants (51.0% females). The mean age of participants in these studies ranged from 41 to 54 years, while average baseline smoking ranged from 14 to 21 cigarettes per day. Compared to NRT, e-cigarette use was associated with lower nicotine abstinence rates at the longest follow-up (risk ratio 0.50 (95% CI 0.32–0.77)). Among successful cigarette quitters, the risk of allocated product use by the end of the observational time was higher for e-cigarette users compared to NRT (risk ratio 8.94 (95% CI 3.98–20.07)). E-cigarette users had higher cigarette smoking cessation rates compared to NRT users (risk ratio 1.58 (95% CI 1.20–2.08)).ConclusionsThe use of e-cigarettes as a therapeutic intervention for smoking cessation may lead to permanent nicotine dependence.

Pharmaceutical interventions: A solution to stop smoking

“… 8 In advanced and rich countries like the USA, the pharma industries are working to ensure the standard of living of people with the help of nicotine gum as an alternative to getting nicotine from tobacco. 5 Moreover, it is not an easy task to influence the attitude of smokers to motivate them to not consume cigarettes Taylor, Claire, Campbell, Coleman-Haynes, Leonardi-Bee, Chamberlain, Berlin, Davey, Cooper, Coleman, 9 but it is an alternative way of therapy for getting betterment. It is noted that most smokers believe that it would be a useless and hard job to reduce the consumption of nicotine because it has become their habit now.…”

“…3 It is believed that with the help of this gum, doctors are improving the standard of living of the people because this gum provides the alternative nicotine to reduce the level of tobacco consumption. 5 Similarly, another alternative for tobacco consumption is a nicotine patch. This way of treatment is also used by the medical field to treat the people of different countries who are involved in tobacco consumption since it was invented by the pharma industry.…”

“…This way of treatment is also used by the medical field to treat the people of different countries who are involved in tobacco consumption since it was invented by the pharma industry. 5 Importantly, the modern treatment for nicotine consumption is nicotine replacement therapy which has a critical impact on smoking behavior of people. 1 In Norway, nicotine replacement therapy is being practiced on a larger scale, to ensure that the large consumption of tobacco should be reduced, and the people must be treated in effective ways for their betterment.…”

“… 6 Also, the behavior of smoking behavior of people refers to the habit and circumstances, in which the smokers are ready to get all the information about their smoking patterns. 5 The behavior of smokers varies from person to person, and it is continuously changing over time.…”

“…Additionally, this study would be useful for designing the strategies for fundamental literary information about the smoker attitude and smoking behavior of the Indian people that would ultimately help the Indian pharma industry to work in a new and targeted direction for getting things differently. 5 Also, the relationship between the theoretical framework of the study would help pharmacist to treat people in a new direction.…”