Electronic cigarettes for smoking cessation

Abstract

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.

The effect of e-cigarettes on smoking cessation and cigarette smoking initiation: An evidence-based rapid review and meta-analysis

“…There were no 26 or one 28 non-critical weakness in two systematic reviews, and these were rated as high confidence according to AMSTAR-2. Three 29 - 31 were rated as low confidence due to the lack of a protocol and inadequate details of the included studies.…”

A pre-post pilot study of electronic cigarettes to reduce smoking in people with severe mental illness

“…Electronic cigarettes (e-cigarettes) can provide smokers with nicotine without the constituents of tobacco that cause cardiovascular and respiratory disease (Public Health England, 2015). They mimic tobacco cigarettes, as behavioural cues (hand-to-mouth actions) are maintained (Prochaska and Grana, 2014; Hartmann-Boyce et al ., 2016). They have good acceptability (Etter and Bullen, 2011 a ) and availability (Chang and Barry, 2015), but their utility as an aid to smoking reduction or cessation is unclear (Hartmann-Boyce et al ., 2018).…”

A systematic review of the impact of cigarettes and electronic cigarettes in otology

“…Currently, it is unknown whether electronic cigarettes are as effective as other nicotine replacement therapies, but their popularity has risen because of their similar method of administration to cigarettes and the variety of flavours available. 5 Despite this, there has been growing concern that these devices could act as a gateway to nicotine addiction and cigarette smoking particularly amongst children and adolescents. 6 Within otology, the effects on middle-ear and inner-ear pathology are largely unknown but in vitro studies and historical animal studies may provide insight into possible effects.…”