Electronic cigarettes for smoking cessation

Lindson, Nicola; Butler, Ailsa R; McRobbie, Hayden; Bullen, Chris; Hajek, Peter; Begh, Rachna; Theodoulou, Annika; Notley, Caitlin; Rigotti, Nancy A; Turner, Tari; Livingstone-Banks, Jonathan; Morris, Tom; Hartmann-Boyce, Jamie

doi:10.1002/14651858.cd010216.pub8

Cited by 31 publications

(17 citation statements)

References 249 publications

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“…Comparisons of the effectiveness of different doses of nicotine in e-cigarettes are limited. 13 One randomised controlled trial (conducted in the USA where higher nicotine strengths are permitted than in the UK) found quit rates were 2.5 times higher among smokers randomised to receive an e-cigarette containing 36 mg/ml e-liquid than those who received 8 mg/ml, but the 95%CI included no difference (RR=2.50 [95%CI 0.80–7.77]). 14 We found that while current smokers tended to use higher-strength e-liquids than long-term ex-smokers, one in three reported using low-strength (<6 mg/ml) or nicotine-free e-cigarettes.…”

Section: Discussionmentioning

confidence: 99%

“…Higher-strength e-liquids provide better relief from withdrawal and satisfy cravings for tobacco 12 and may therefore be more effective for helping prevent relapse. 13 Making these products more expensive could disincentivise their use and drive vapers towards cheaper, lower-strength e-liquids. This could potentially undermine smoking cessation 14 or result in increased use of e-liquid to compensate 15 (including among young vapers not trying to quit smoking), thus increasing potential toxicant exposure and associated risks to health.…”

Section: Introductionmentioning

confidence: 99%

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Nicotine strength of e-liquids used by adult vapers in Great Britain: a population survey 2016 to 2024

Jackson,

Brown,

Shahab

et al. 2024

Preprint

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Background/Aims: In March-2024, the UK government announced plans to introduce a new Vaping Products Duty that will tax e-liquids based on their nicotine strength. This study examined trends in the nicotine strength of e-liquids used by adult vapers and differences in those currently used across relevant subgroups. Design: Nationally-representative, cross-sectional household survey, July-2016 to January-2024. Setting: Great Britain. Participants: 7,957 adult vapers. Main outcome measures: Participants were asked whether the e-cigarette they mainly use contains nicotine and the e-liquid strength. We used logistic regression to estimate time trends in different nicotine strengths used (no nicotine/>0-≤6/7-11/12-19/≥20 mg/ml), overall in England and stratified by main device type (disposable/refillable/pod), age (≥18y), and smoking status. We explored current differences in nicotine strength among those surveyed between January-2022 and January-2024 in Great Britain by main device type, age (≥16y), gender, occupational social grade, history of ≥1 mental health conditions, smoking status, and (among past-year smokers) level of cigarette addiction. Results: The proportion of vapers in England using high-strength (≥20mg/ml) e-liquids increased from an average of 3.8% [95%CI 2.9-5.0%] up to June-2021 to 32.5% [27.9-37.4%] in January-2024 (when 93.3% reported using exactly 20mg/ml). This rise was most pronounced among those using disposable e-cigarettes, those aged 18-24y, and all smoking statuses (including never smokers) except long-term (≥1y) ex-smokers. Of those surveyed in 2022-24 in Great Britain, overall, 89.5% [88.1-90.8%] said they usually used e-cigarettes containing nicotine, 8.7% [7.5-10.0%] used nicotine-free e-cigarettes, and 1.8% [1.2-2.4%] were unsure. The proportion using ≥20mg/ml was higher among those mainly using disposable (47.9%) compared with pod (16.3%) or refillable (11.5%) devices; never smokers (36.0%), current smokers (28.8%), or recent (<1y) ex-smokers (27.4%), compared with long-term ex-smokers (13.9%); and younger (16-24y; 44.2%) compared with older (≥25y; range 9.4-25.1%) age groups. There were no notable differences across other subgroups of interest. Conclusions: Use of high-strength nicotine e-liquids in England has increased sharply in recent years. Most adult vapers in Great Britain use e-cigarettes that contain nicotine but different subgroups use different strengths: they tend to be higher among those who mainly use disposable devices, those aged 16-24y, and lower among long-term ex-smokers.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Nicotine strength of e-liquids used by adult vapers in Great Britain: a population survey 2016 to 2024

Jackson,

Brown,

Shahab

et al. 2024

Preprint

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“…Kohortenstudien, in denen E-Zigaretten entweder zur Unterstützung der Raucherentwöhnung oder als Ersatz für Tabakzigaretten verwendet wurden, haben keine Wirksamkeit im Hinblick auf eine erfolgreiche Raucherentwöhnung oder bei der Verhinderung eines Rückfalls gezeigt [23,24]. Primärer Endpunkt eines aktuellen systematischen Cochrane-Reviews, in denen der Nutzen von E-Zigaretten in klinischen Studien zur Raucherentwöhnung untersucht wurde, war die Rauchabstinenz nach mindestens 6 Monaten Nachbeobachtungszeit [25]. Die Autoren stellten mit hoher Sicherheit fest, dass die Raucherentwöhnungsrate bei Personen, die randomisiert nikotinhaltige E-Zigaretten erhielten, höher ist als bei Personen, die ebenfalls randomisiert Nikotinersatztherapie erhielten (relatives Risiko: 1,59; 95 %-Konfidenzintervall: 1,29-1,93).…”

Section: E-zigaretten Zur Raucherentwöhnungunclassified

“…In Übereinstimmung mit den Ergebnissen einer Metaanalyse von randomisiert-kontrollierten klinischen Studien [32] unterschieden sich im Hinblick auf den vollständigen Ausstieg Rau-▶ Tab. 1 Konsummuster 6 Monate nach der Randomisierung (nach [36] [25,37].…”

Section: Transparenz In Der Darstellung Von Studienergebnissen: Ein B...unclassified

Beabsichtigte und unbeabsichtigte Wirkungen von E-Zigaretten in klinischen Studien – ein Plädoyer für (mehr) Transparenz

Hanewinkel,

Ulbricht

2024

Pneumologie

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ZusammenfassungE-Zigaretten werden in klinischen Studien zur Tabakentwöhnung eingesetzt. Aufgrund der Gesundheitsrisiken, die mit dem Gebrauch von E-Zigaretten verbunden sind, sollten die Ergebnisse klinischer Studien vollständig berichtet werden, einschließlich des fortgesetzten ausschließlichen Gebrauchs und des gemeinsamen Gebrauchs von Tabak und E-Zigaretten. Die Ergebnisse zur Nikotinentwöhnung sollten als primärer Endpunkt ebenso wie die Analyse der bloßen Beendigung des Tabakkonsums berichtet werden. Da es derzeit keine stichhaltigen Belege dafür gibt, dass die Reduzierung des Zigarettenkonsums wesentliche gesundheitliche Vorteile mit sich bringt, sollte die Reduzierung des Zigarettenkonsums nicht als Gesundheitsendpunkt in klinischen Studien verwendet werden. Die fortbestehende Nikotinabhängigkeit sollte als „unerwünschtes Ereignis“ in die Berichterstattung über die Studienergebnisse aufgenommen werden.

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“…As an alternative to conventional tobacco products, e-cigarettes are experiencing a swift surge in popularity among the youth demographic in Europe, America, and China, attributable to their diverse flavors, stylish esthetics, and user-friendly design ( 1 , 2 ). There is robust evidence indicating that e-cigarettes containing nicotine exhibit a higher efficacy in promoting smoking cessation rates when contrasted with nicotine-free counterparts ( 3 , 4 ). In contrast to tobacco smoke, which comprises thousands of chemicals, e-cigarettes are devoid of tobacco, obviate the need for combustion, and eschew the production of sidestream smoke.…”

Section: Introductionmentioning

confidence: 99%

Comparison of bladder carcinogenesis biomarkers in the urine of traditional cigarette users and e-cigarette users

Feng,

Huang,

Peng

et al. 2024

Front. Public Health

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BackgroundDuring the use of electronic cigarettes (e-cigarettes), users are still exposed to carcinogens similar to those found in tobacco products. Since these carcinogens are metabolized and excreted in urine, they may have carcinogenic effects on the bladder urinary tract epithelium. This meta-analysis aimed to compare bladder cancer carcinogens in the urine of tobacco users and e-cigarette users using a large number of samples.MethodsA systematic meta-analysis was performed using data obtained from several scientific databases (up to November 2023). This cumulative analysis was performed following the Preferred Reporting Items for Systematic Evaluation and Meta-Analysis (PRISMA) and Assessing the Methodological Quality of Systematic Evaluations (AMSTAR) guidelines, according to a protocol registered with PROSPERO. This study was registered on PROSPERO and obtained the unique number: CRD42023455600.ResultsThe analysis included 10 high-quality studies that considered polycyclic aromatic hydrocarbons (PAHs), volatile organic compounds (VOCs) and tobacco-specific nitrosamines (TSNAs). Statistical indicators show that there is a difference between the tobacco user group and the e-cigarette user group in terms of 1-Hydroxynaphthalene (1-NAP) [weighted mean difference (WMD)10.14, 95% confidence interval (CI) (8.41 to 11.88), p < 0.05], 1-Hydroxyphenanthrene (1-PHE) [WMD 0.08, 95% CI (−0.14 to 0.31), p > 0.05], 1-Hydroxypyrene (1-PYR) [WMD 0.16, 95% CI (0.12 to 0.20), p < 0.05], 2-Hydroxyfluorene (2-FLU) [WMD 0.69, 95% CI (0.58 to 0.80), p < 0.05], 2-Hydroxynaphthalene (2-NAP) [WMD 7.48, 95% CI (4.15 to 10.80), p < 0.05], 3-Hydroxyfluorene (3-FLU) [WMD 0.57, 95% CI (0.48 to 0.66), p < 0.05], 2-Carbamoylethylmercapturic acid (AAMA) [WMD 66.47, 95% CI (27.49 to 105.46), p < 0.05], 4-Hydroxy-2-buten-1-yl-mercapturic acid (MHBMA) [WMD 287.79, 95% CI (−54.47 to 630.04), p > 0.05], 4-(Methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNAL) [WMD 189.37, 95% CI (78.45 to 300.29), p < 0.05], or N0-nitrosonornicotine (NNN) [WMD 11.66, 95% CI (7.32 to 16.00), p < 0.05].ConclusionUrinary bladder cancer markers were significantly higher in traditional tobacco users than in e-cigarette users.Systematic review registration: PROSPERO (CRD42023455600: https://www.crd.york.ac.uk/PROSPERO/).

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Electronic cigarettes for smoking cessation

Cited by 31 publications

References 249 publications

Nicotine strength of e-liquids used by adult vapers in Great Britain: a population survey 2016 to 2024

Nicotine strength of e-liquids used by adult vapers in Great Britain: a population survey 2016 to 2024

Beabsichtigte und unbeabsichtigte Wirkungen von E-Zigaretten in klinischen Studien – ein Plädoyer für (mehr) Transparenz

Comparison of bladder carcinogenesis biomarkers in the urine of traditional cigarette users and e-cigarette users

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