Historique
Article de Périodique
Longer-term use of electronic cigarettes when provided as a stop smoking aid: Systematic review with meta-analyses (2022)
Auteur(s) :
BUTLER, A. R. ;
LINDSON, N. ;
FANSHAWE, T. R. ;
THEODOULOU, A. ;
BEGH, R. ;
HAJEK, P. ;
McROBBIE, H. ;
BULLEN, C. ;
NOTLEY, C. ;
RIGOTTI, N. A. ;
HARTMANN-BOYCE, J.
Année :
2022
Page(s) :
art. 107182
Sous-type de document :
Méta-analyse / Meta-analysis ; Revue de la littérature / Literature review
Langue(s) :
Anglais
Domaine :
Tabac / Tobacco / e-cigarette
Discipline :
EPI (Epidémiologie / Epidemiology)
Résumé :
Moderate certainty evidence supports use of nicotine electronic cigarettes to quit smoking combustible cigarettes. However, there is less certainty regarding how long people continue to use e-cigarettes after smoking cessation attempts. We set out to synthesise data on the proportion of people still using e-cigarettes or other study products at 6 months or longer in studies of e-cigarettes for smoking cessation.
We updated Cochrane searches (November 2021). For the first time, we meta-analysed prevalence of continued e-cigarette use among individuals allocated to e-cigarette conditions, and among those individuals who had successfully quit smoking. We updated meta-analyses comparing proportions continuing product use among individuals allocated to use nicotine e-cigarettes and other treatments.
We included 19 studies (n = 7787). The pooled prevalence of continued e-cigarette use at 6 months or longer was 54% (95% CI: 46% to 61%, I² 86%, N = 1482) in participants assigned to e-cigarette conditions. Of participants who had quit combustible cigarettes overall 70% were still using e-cigarettes at six months or longer (95% CI: 53% to 82%, I² 73%, N = 215). Heterogeneity in direction of effect precluded meta-analysis comparing long-term use of nicotine e-cigarettes with NRT. More people were using nicotine e-cigarettes at longest follow-up compared to non-nicotine e-cigarettes, but CIs included no difference (risk ratio 1.15, 95% CI: 0.94 to 1.41, n = 601). The levels of continued e-cigarette use observed may reflect the success of e-cigarettes as a quitting tool. Further research is needed to establish drivers of variation in and implications of continued use of e-cigarettes.
Highlights:
• First meta-analysis of continued e-cigarette use when provided in a stop-smoking trial setting.
• 54% of people given an e-cigarette to help them stop smoking were using e-cigarettes at 6 months.
• 70% of successful combustible cigarette quitters were still using e-cigarettes at 6 months.
• Longer-term use could be a mechanism of e-cigarette success, by preventing relapse to smoking.
• Safety implications to be balanced against the negative effects of continued tobacco smoking.
We updated Cochrane searches (November 2021). For the first time, we meta-analysed prevalence of continued e-cigarette use among individuals allocated to e-cigarette conditions, and among those individuals who had successfully quit smoking. We updated meta-analyses comparing proportions continuing product use among individuals allocated to use nicotine e-cigarettes and other treatments.
We included 19 studies (n = 7787). The pooled prevalence of continued e-cigarette use at 6 months or longer was 54% (95% CI: 46% to 61%, I² 86%, N = 1482) in participants assigned to e-cigarette conditions. Of participants who had quit combustible cigarettes overall 70% were still using e-cigarettes at six months or longer (95% CI: 53% to 82%, I² 73%, N = 215). Heterogeneity in direction of effect precluded meta-analysis comparing long-term use of nicotine e-cigarettes with NRT. More people were using nicotine e-cigarettes at longest follow-up compared to non-nicotine e-cigarettes, but CIs included no difference (risk ratio 1.15, 95% CI: 0.94 to 1.41, n = 601). The levels of continued e-cigarette use observed may reflect the success of e-cigarettes as a quitting tool. Further research is needed to establish drivers of variation in and implications of continued use of e-cigarettes.
Highlights:
• First meta-analysis of continued e-cigarette use when provided in a stop-smoking trial setting.
• 54% of people given an e-cigarette to help them stop smoking were using e-cigarettes at 6 months.
• 70% of successful combustible cigarette quitters were still using e-cigarettes at 6 months.
• Longer-term use could be a mechanism of e-cigarette success, by preventing relapse to smoking.
• Safety implications to be balanced against the negative effects of continued tobacco smoking.
Affiliation :
Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK