Effect of Electronic Cigarettes on Smoking Reduction and Cessation in Korean Male Smokers: A Randomized Controlled Study

Lee, Seung Hwa; Ahn, Sanghyun; Cheong, Yoo Seock

doi:10.3122/jabfm.2019.04.180384

Cited by 58 publications

(101 citation statements)

References 23 publications

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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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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%

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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“…The analysis was an intention to treat in almost all of the studies. 14,22 -28 One study reported lost follow up at an early stage of allocation rather than after randomization 29 and one study reported that percent of patients lost to follow up are similar in all arms of the study. 30…”

Section: Methodsmentioning

confidence: 99%

Efficacy of Electronic Cigarettes for Smoking Cessation: A Systematic Review and Meta-Analysis

2020

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Background: Smoking is a major public health problem and widely recognized as one cause of premature morbidity and mortality. No updated evidence to conclude about the certainty of evidence for adopting E-Cigarettes as smoking cessation intervention despite enough debate. We aim to synthesize available evidence to assess the efficacy as well as safety of E-Cigarettes versus different forms of NRT and placebo to quit smoking. Methods: We comprehensively searched of clinical trials in Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (via PubMed), PsycINFO, Science Direct, Center for reviews and dissemination and HTA database and Trip database. We also searched clinicalTrial.gov and WHO International Clinical Trials Registry Platform (ICTRP) portal. We searched grey literature including Dissertations (ProQuest Dissertations and Theses), Web of Science Thomson Reuters: Conference Proceedings Citation Index, and unpublished manuscripts, examined the references of relevant articles, hand searched topic-specific journals and contacted authors for incomplete data. After data extraction, we assessed the risk of bias using the Cochrane RoB 2 tool. We synthesized data by random-effects model through the Mantel-Haenszel method and R software. We conducted subgroup analysis by length of follow-up and sensitivity analysis by restricting to only studies with low risk of bias. We created a summary of findings table based on GRADE approach. Results: We retrieved 12 clinical trials involving 9863 participants. Four studies were judged as low risk of bias across five domains of RoB 2 tool and the rest were judged as unclear risk of bias. CO- validated one-month continuous abstinence rate was significantly higher in E-cigarettes group than control (5 studies, 32.6 vs 23.1%, N = 1970, RR 1.335, 95 % CI 1.068; 1.667, moderate evidence). However, Three-month and six- month abstinence rate didn’t differ significantly between E-cigarettes and control groups (3 Studies, 12.1 vs 12.8%, N=1099, RR 1.52, 95% CI 0.348; 6.701) and (7studies, N = 5435,10.2 vs 6.6%, RR 1.347, 95%CI 0.953; 1.903, very low evidence) respectively. There is very low certainty evidence of effect of E-cigarettes compared to control whether NRT or placebo on sustained reduction of 50% or greater in baseline cigarette consumption at different follow-up periods (1 month, 3 studies, 50.9 vs 33.2%, N = 955, RR 1.29, 95 % CI 0.59; 2.82), (3 Month , 3 studies, 43.2 vs 25.3%, N = 1067, RR 1.36, 95 % CI 0.66; 2.79), (6 month , 5 studies, 27.1 vs 13.4%, N = 1981, RR 1.38, 95 % CI 0.90; 2.11) and at 12 month (1 study, 14.5 vs 12%, N = 300, RR 1.21, 95 % CI 0.64; 2.27). Only one study of 884 participants displayed improved point abstinence by 46% (improvement range 17-82%) in E-cigarettes group relative to control at 12 months (1study, 32.7 vs 22.3%, N = 884, RR 1.46, 95 % CI 1.17; 1.82, moderate evidence). E-cigarettes may increase the proportion of serious adverse effect at 6 month-follow up (1 study, 9.3 vs 5.1%, N = 657, RR 1.81, 95 % CI 1.03; 3.19, low evidence) Conclusion: We are uncertain if E-cigarettes improve continuous abstinence rate at short term (1 month). There is very low certainty evidence of the effect of E-cigarettes compared to control whether NRT or placebo on the sustained reduction of 50% or greater in baseline cigarette consumption as well as 7-day point prevalence abstinence rate at 1-,3-, and 6-month follow-up periods. Long term efficacy of E-cigarettes is unknown, and E-cigarettes may increase or have no effects on the proportion of serious adverse effect at 6 months follow up. The information presented are indeed useful for policy makers , public health practitioners, and to encourage further research. Further clinical trials are needed to assess the long-term efficacy and safety of E-cigarettes and ongoing trials are urgently needed to help concluding about the efficacy of E-cigarettes for smoking cessation. Objective: to synthesize evidence about the efficacy of electronic cigarettes versus Nicotine Replacement Therapy and placebo to quit smoking. Data sources: We searched for clinical trials with no publication date restriction until December 2019. The search included CENTRAL, MEDLINE, PsycINFO, Science Direct, Center for reviews and dissemination and HTA database and Trip database, clinical trials registries, gray literature and examined the references of relevant articles. Inclusion and exclusion criteria: Two review authors independently checked the titles and abstracts then the full text of initial hits. Main outcomes were sustained continuous abstinence rate, 7-day point prevalence abstinence rate, sustained reduction of 50% or greater in baseline cigarette consumption and adverse effects. Data extraction and synthesis: Two review authors independently extracted data and assessed risk of bias using the Cochrane RoB 2 tool. We conducted a random-effects model through the Mantel-Haenszel method. Results: We retrieved 12 trials involving 9863 participants. CO- validated 1-month continuous abstinence rate improved by 33% in the e-cigarettes group (range 6-66%, moderate evidence). We are uncertain if e-cigarettess influence continuous abstinence rate at 3-, 6- and 12 months as well as sustained reduction of 50% or greater in baseline cigarette consumption at different follow-up periods. One study of 884 participants displayed improved 12-month 7-day point abstinence by 46% (range 17%-82%). E-cigarettes may increase or do not affect the proportion of serious adverse effect at 6 and 12 months follow up. Conclusion: Very low certainty evidence supported e-cigarettess to help quit smoking in the short term. There is not enough evidence to determine if e-cigarettess are a safe and efficacious means of smoking cessation in the long term (12+ months).

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“…Thankfully, the article includes specific handouts that can be used for provider training. In an article from Korean family physicians, Lee et al 17 undertook a randomized trial of e-cigarettes compared with nicotine gum to help people stop smoking. These data add another choice to the options for patients.…”

Section: Substance Usementioning

confidence: 99%

Implementing Practice Changes in Family Medicine to Enhance Care and Prevent Disease Progression

Bowman¹,

Seehusen

Neale³

2019

J Am Board Fam Med

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This issue epitomizes family medicine with a heavy emphasis on research to prevent illness and illness progression. Which patients will experience significant symptomatic knee osteoarthritis? Do the elderly use retail clinics, and what is the impact on care for chronic conditions? Does capitation payment enhance or decrease same-day access? How do primary care practices risk stratify to provide integrated care? Can risk screening and on-site providers enhance psychiatric care? What screening questions should we ask adolescents, to identify problematic drug use? A report on a practice intervention to improve opioid prescribing practices, and another on the significant level of depression in many patients taking opioid medications. Which works better for smoking cessation-e-cigarettes or nicotine gum? Reminders about teratogenic drugs and those that cause hyperpigmentation. Interdisciplinary care with pharmacists in the office does not help just the patients. We have several articles on diabetes-early diagnosis, and consideration of screening for prediabetes as a quality standard-with added commentaries about this possibility. (J Am Board Fam Med 2019;32:451-453.

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Effect of Electronic Cigarettes on Smoking Reduction and Cessation in Korean Male Smokers: A Randomized Controlled Study

Cited by 58 publications

References 23 publications

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

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

Efficacy of Electronic Cigarettes for Smoking Cessation: A Systematic Review and Meta-Analysis

Implementing Practice Changes in Family Medicine to Enhance Care and Prevent Disease Progression

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