Electronic Cigarette Use During a Randomized Trial of Interventions for Smoking Cessation Among Medicaid Beneficiaries with Mental Illness

Bianco, Cynthia; Pratt, Sarah I.; Ferron, Joelle C.; Brunette, Mary F.

doi:10.1080/15504263.2019.1620400

Cited by 13 publications

(9 citation statements)

References 23 publications

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“…Among the 24 ORs of all people who smoke in which a range of study characteristics were reported, these characteristics (cross-sectional vs longitudinal study design, whether e-cigarette studies. 12,22,24,27,29,30,35,41,44,46,51,53,57,60,61,65,66,68,69,71 In this population, the point estimate for the effect of e-cigarettes on smoking cessation was below the null, but the 95% CI did not exclude the possibility of a very small positive effect on smoking cessation (OR = 0.851; 95% CI = 0.684, 1.057; P = .143; Figure 2 and 13,14,22,23,28,32,38,39,45,49,52,55,56,64,67 Compared with no e-cigarette use, daily e-cigarette use was associated with significantly higher odds of smoking cessation (OR = 1.529; 95% CI = 1.158, 2.019; P = .005; Figure 3 and Table 3).…”

Section: Resultsmentioning

confidence: 99%

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: Resultsmentioning

confidence: 99%

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

2021

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“…The average number of cigarettes smoked ranged from 13 to 21 cigarettes per day. Nicotine dependence using the Fagerstrom test of cigarette dependence was less than 5 in 3 studies, 14,24,29 more than 5 in 6 studies 23,26 -28,33,34 and not reported in 3 studies. Nine of included studies reported participants attempts to quit smoking while it’s unclear in 3 studies.…”

Section: Resultsmentioning

confidence: 92%

“…We included 12 clinical trials involving 9863 participants. 4,22 -30,33,34 Mean age for each trial ranged from 28-53 years old . Male predominance ranged from 30 to 100%.…”

Section: Resultsmentioning

confidence: 99%

“…Four studies were judged as a low risk of bias overall 5 domains of RoB 2 tool 4,24,26,29 and the rest 8 studies were judged as unclear risk of bias. Random sequence generation was done by a computer-generated randomization sequence in 8 studies 4,23,24,26 -29,33 or randomly permuted blocks of different sizes in 2 studies 25,34 while unclear in 2 studies. 22,30 For allocation concealment domain, we judged 6 studies as unclear risk 22,23,28,30,33,34 and 6 studies as low risk of bias.…”

Section: Resultsmentioning

confidence: 99%

“…Random sequence generation was done by a computer-generated randomization sequence in 8 studies 4,23,24,26 -29,33 or randomly permuted blocks of different sizes in 2 studies 25,34 while unclear in 2 studies. 22,30 For allocation concealment domain, we judged 6 studies as unclear risk 22,23,28,30,33,34 and 6 studies as low risk of bias. 4,24 -27,29 For blinding of participants, personnel and outcome measurement, all studies except one had low risk of bias.…”

Section: Resultsmentioning

confidence: 99%

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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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Electronic cigarettes for smoking cessation

Huhndorf¹,

Curtis²,

Neher³

et al. 2020

Cochrane Database of Systematic Reviews

262

196

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Background Electronic 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. Objectives To evaluate the safety and effect of using ECs to help people who smoke achieve long-term smoking abstinence. Search methods We 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 criteria We 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 analysis We 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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Electronic Cigarette Use During a Randomized Trial of Interventions for Smoking Cessation Among Medicaid Beneficiaries with Mental Illness

Cited by 13 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

Electronic cigarettes for smoking cessation

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