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Studies on effects of e-cigarettes on smoking cessation unreliable

4 months ago
The Hong Kong government has insisted a cigarette packaging reform is vital to discourage smoking.

More studies of good quality are needed to determine the impacts of electronic nicotine delivery systems or electronic non-nicotine delivery systems on cessation of smoking, a new meta-analysis recommends. The current existing literature is not of high enough quality or certainty to yield meaningful conclusions.

Studies published in the Cochrane Central Register of Controlled Trials, Embase, Medline, Cinahl, PsychInfo and Web of Science were screened for randomized controlled trials and prospective cohort studies that investigated electronic nicotine or non-nicotine delivery systems.

Those that had a sample of smokers, compared the interventions to no cessation aids and alternative cessation aids were included. Outcomes of the studies were smoking cessation, at least 50 percent reduction in cigarette use and adverse events.

After applying the inclusion and exclusion criteria, only three randomized controlled trials corresponding to 1,007 individuals, and 9 prospective cohort studies corresponding to 13,115 individuals were found to be eligible for analysis.

Analysis of two randomized controlled trials showed that using electronic nicotine delivery systems may result in greater smoking cessation compared to electronic non-nicotine delivery systems (risk ratio [RR], 2.03; 95 percent CI, 0.94 to 4.38; p=0.07).

On the other hand, analysis of eight cohort studies reported no significant improvements in smoking cessation when electronic nicotine delivery systems were employed compared to no such system (odds ratio [OR], 0.74; 0.55 to 1.00; p=0.051).

In the analysis of both types of studies, confidence in the evidence was rated as low because of risk of bias and imprecise data, both of which were attributed to lack of blinding, missing outcome data and imprecision in assessment.

Sensitivity analyses in both randomized controlled trials and cohort studies showed inconsistencies with the findings from the primary synthesised analyses.

The results of the meta-analysis thus show that existing literature on using either electronic nicotine or non-nicotine delivery systems for smoking cessation is insufficient and of not high enough quality to draw any meaningful conclusions. 

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Most Read Articles
18 days ago
Regardless of dosing, nonvitamin K antagonist oral anticoagulants (NOACs) are more effective than warfarin for atrial fibrillation and safer in Asian than in non-Asian populations, a new meta-analysis shows.
6 days ago
Nonalcoholic fatty liver diseases (NAFLD) and serum concentrations of alanine transaminase (ALT), aspartate transaminase (AST), gamma-glutamyltransferase (GGT) and alkaline phosphatase (ALP) are independent predictors of incident type 2 diabetes, a new prospective study shows.
5 days ago
There appears to be no evidence supporting associations between physical activity and asthma control level, spirometric measurements and quality of life in children and adolescents with asthma, according to a study from Brazil.
5 days ago
There is a growing number of targeted therapies being approved for use in cancer therapy in the home setting, and this poses a potential risk among family member and caregivers, particularly those of reproductive risk age, a recent study suggests.