Abstract
Objectives
E-cigarettes are increasingly popular as smoking cessation aids. This review assessed the efficacy of e-cigarettes for smoking cessation as well as desire to smoke, withdrawal symptoms, and adverse events in adult smokers.
Methods
A systematic review was conducted. Studies comparing e-cigarettes to other nicotine replacement therapies or placebo were included. Data were pooled using meta-analysis.
Results
Of 569 articles, 5 were eligible. Study participants were more likely to stop smoking when using nicotine e-cigarettes (43/489, 9 %) versus placebo e-cigarettes (8/173, 5 %); however, this difference was not statistically significant (RR 2.02; 95 % CI 0.97, 4.22). The pooled effect estimates for the desire to smoke (RR −0.22; 95 % CI −0.80, 0.36), irritability (RR −0.03; 95% CI −0.38, 0.31), restlessness (RR −0.03; 95 % CI −0.42, 0.35), poor concentration (RR −0.01; 95 % CI −0.35, 0.32), depression (RR −0.01; 95 % CI −0.22, 0.20), hunger (RR −0.01; 95 % CI −0.32, 0.30), and average number of non-serious adverse events (RR −0.09; 95 % CI −0.28, 0.46) were not statistically significantly different. Only one study reported serious adverse events with no apparent association with e-cigarette use.
Conclusions
Limited low-quality evidence of a non-statistically significant trend toward smoking cessation in adults using nicotine e-cigarettes exists compared with other therapies or placebo. Larger, high-quality studies are needed to inform policy decisions.
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References
Action on Smoking and Health (ASH) (2014) Electronic cigarettes. http://www.ash.org.uk/files/documents/ASH_715.pdf
Akl EA, Briel M, You JJ et al (2012) Potential impact on estimated treatment effects of information lost to follow-up in randomised controlled trials (LOST-IT): systematic review BMJ Br Med J 344
Altman DG, Bland JM (2003) Interaction revisited: the difference between two estimates Bmj 326:219
Bam TS, Bellew W, Berezhnova I et al (2014) Position statement on electronic cigarettes or electronic nicotine delivery systems. Int J Tuberc Lung Dis 18:5–7. doi:10.5588/ijtld.13.0815
Buck SF (1960) A method of estimation of missing values in multivariate data suitable for use with an electronic computer. J Royal Stat Soc Series B (Methodological) 22:302–306
Bullen C, McRobbie H, Thornley S et al (2010) Effect of an electronic nicotine delivery device (e cigarette) on desire to smoke and withdrawal, user preferences and nicotine delivery: randomised cross-over trial. Tobacco Control 19:98–103
Bullen C, Howe C, Laugesen M et al (2013) Electronic cigarettes for smoking cessation: a randomised controlled trial. Lancet 382:1629–1637
Caponnetto P, Campagna D, Papale G et al (2012) The emerging phenomenon of electronic cigarettes. Exp Rev Respir Med 6:63–74. doi:10.1586/ers.11.92
Caponnetto P, Campagna D, Cibella F et al (2013) EffiCiency and safety of an eLectronic cigAreTte (ECLAT) as tobacco cigarettes substitute: a prospective 12-month randomized control design study. PLoS One 8:e66317
Dawkins L, Turner J, Hasna S et al (2012) The electronic-cigarette: effects on desire to smoke, withdrawal symptoms and cognition. Addict Behav 37:970–973
Dawkins L, Turner J, Crowe E (2013) Nicotine derived from the electronic cigarette improves time-based prospective memory in abstinent smokers. Psychopharmacology 227:377–384
Etter JF, Bullen C (2011) Electronic cigarette: users profile, utilization, satisfaction and perceived efficacy. Addiction 106:2017–2028
Farsalinos KE, Polosa R (2014) Safety evaluation and risk assessment of electronic cigarettes as tobacco cigarette substitutes: a systematic review. Ther Adv Drug Saf 5:67–86. doi:10.1177/2042098614524430
Fidler J, Shahab L, West O et al (2011) ‘The smoking toolkit study’: a national study of smoking and smoking cessation in England. BMC Public Health 11:479
Franck C, Budlovsky T, Windle SB et al (2014) Electronic cigarettes in North America history, use, and implications for smoking cessation. Circulation 129:1945–1952
Harrell PT, Simmons VN, Correa JB et al (2014) Electronic nicotine delivery systems (“e-cigarettes”): review of safety and smoking cessation efficacy. Otolaryngol Head Neck Surg 151:381–393
Higgins JPT, Green S (2011) Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. Cochrane Collaboration
Hughes JR, Keely J, Naud S (2004) Shape of the relapse curve and long-term abstinence among untreated smokers. Addiction 99:29–38
McRobbie H, Bullen C, Hartmann-Boyce J et al (2014) Electronic cigarettes for smoking cessation and reduction. Cochrane Database Syst Rev. doi:10.1002/14651858.CD010216.pub2
Medicines and Healthcare Products Regulatory Agency (MHRA) (2014) Press release: UK moves towards safe and effective electronic cigarettes and other nicotine-containing products
Orr KK, Asal NJ (2014) Efficacy of electronic cigarettes for smoking cessation. Ann Pharmacotherap 1060028014547076
Pepper JK, Brewer NT (2013) Electronic nicotine delivery system (electronic cigarette) awareness, use, reactions and beliefs: a systematic review. Tobacco Control
Polosa R, Benowitz NL (2011) Treatment of nicotine addiction: present therapeutic options and pipeline developments. Trends Pharmacol Sci 32:281–289
Polosa R, Caponnetto P, Morjaria J et al (2011) Effect of an electronic nicotine delivery device (e-Cigarette) on smoking reduction and cessation: a prospective 6-month pilot study. BMC Public Health 11:786
Polosa R, Morjaria J, Caponnetto P et al (2014) Effectiveness and tolerability of electronic cigarette in real-life: a 24-month prospective observational study. Intern Emerg Med 9:537–546
Stanbrook MB (2013) Regulate e-cigarettes as drug-delivery devices. Can Med Assoc J
World Health Organization (2014) Tobacco. Geneva
Yamin CK, Bitton A, Bates DW (2010) E-cigarettes: a rapidly growing internet phenomenon. Ann Intern Med 153:607–609. doi:10.7326/0003-4819-153-9-201011020-00011
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Author contribution statement
SK and DO designed the systematic review and meta-analysis protocol. SK and KC created the search strategy. SK and TD searched for publications, and did the review and data extraction, and LL helped with the disagreements. SK, DO, and RΒ developed the analysis frame. SK and TD did the analysis, and SK and DO critically interpreted the results. SK drafted the article, and all authors provided critical revision of the article.
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This article is part of the special issue “Electronic Cigarettes and Public Health”.
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Khoudigian, S., Devji, T., Lytvyn, L. et al. The efficacy and short-term effects of electronic cigarettes as a method for smoking cessation: a systematic review and a meta-analysis. Int J Public Health 61, 257–267 (2016). https://doi.org/10.1007/s00038-016-0786-z
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DOI: https://doi.org/10.1007/s00038-016-0786-z