scholarly journals Electronic cigarette use and smoking reduction – longitudinal data from CONSTANCES cohort study

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
R Gomajee ◽  
F El-Khoury ◽  
M Goldberg ◽  
M Zins ◽  
C Lemogne ◽  
...  

Abstract Aims Electronic cigarettes are often used by smokers to stop smoking and former smokers to prevent relapse. We examined whether electronic cigarette use lead to smoking reduction and cessation among smokers, and relapse among former smokers. Design and Settings The CONSTANCES cohort, France (2012 - ongoing). Measurements Among smokers (N = 5,400, average follow-up of 23.4 months), mixed regression models were used to examine whether electronic cigarette use was linked to a decrease in the number of cigarettes smoked per day and Poisson regression models with sandwich variance estimators were used to test smoking cessation. In parallel, Cox proportional hazards regression models were used to examine the relationship between electronic cigarettes use and smoking relapse among former smokers who stopped smoking since 2010 (N = 2,025, average follow-up of 22.1 months), year in which electronic cigarettes were introduced in France. All statistical analyses were adjusted for socio-demographic characteristics, duration of follow-up, and smoking characteristics. Findings There was a significantly higher decrease in the number of cigarettes smoked/day among smokers who used electronic cigarettes (decrease of 4.4 cigarettes/day) compared to those who did not (decrease of 2.7 cigarettes/day), as well as a higher relative risk of smoking cessation (adjusted RR: 1.67 [95% CI: 1.51-1.84]). At the same time, among former smokers, EC use was associated with an increase in the rate of smoking relapse (adjusted HR = 1.70 [95% CI: 1.25-2.30]). Conclusions After a follow-up of approximately 2 years, electronic cigarettes use among smokers was associated to a decrease in smoking level and an increase in smoking cessation attempts but among former smokers it was associated to a higher risk of smoking relapse. Key messages Among smokers, electronic cigarette use was associated to smoking reduction and smoking cessation. Among former smokers who quit smoking since 2010, electronic cigarette use was associated to a higher likelihood of relapse.

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
T O'Dowd

Abstract Background Worldwide smoking remains the leading cause of preventable morbidity and mortality. Electronic cigarettes (ECs) are increasingly used by tobacco smokers as an aid to smoking cessation; however, their efficacy remains uncertain. Methods Electronic databases, clinical trial registries and grey literature sources were searched. The aim was to examine randomised controlled trials or prospective cohort studies, published since the 2016 Cochrane review on this topic, that assessed the efficacy of ECs in achieving smoking cessation among current smokers. Results Two RCTs and five cohort studies, including a total of 16,460 participants, were eligible for inclusion. One RCT found sustained 1-year abstinence of 18.0% in the EC group versus 9.9% in the nicotine replacement therapy group (RR: 1.83; 95% CI 1.30 to 2.58; P < 0.001). The second RCT did not find a statistically significant difference in abstinence rates between EC users and non-users (RR 0.71). Of the five included cohort studies, four reported statistically significant RRs. Two found a positive association (RRs of 1.45 and 1.84) between EC use and smoking cessation but two studies showed EC use was associated with reduced smoking cessation (RRs of 0.25 and 0.35). Due to significant heterogeneity between the studies the data were deemed unsuitable for pooling into a meta-analysis. All trials assessing smoking reduction reported higher rates of reduction among EC users. No serious adverse events were reported with EC use. Follow-up periods of included trials ranged from one to four years, with an average of 1.6 years. Conclusions There is limited, low-quality evidence that ECs are an effective intervention for smoking cessation and smoking reduction. The overall quality of evidence is low as it is based on a small number of studies with inconsistent and imprecise results. Due to the short follow-up periods of the included trials, the long-term safety of ECs is unclear from this review. Key messages Limited evidence that electronic cigarettes are an effective smoking cessation intervention. Further well-designed randomised controlled trials are required to investigate the efficacy of ECs for smoking cessation.


2020 ◽  
Vol 30 (1) ◽  
pp. 71-76
Author(s):  
Konstantinos E Farsalinos ◽  
Anastasia Barbouni

ObjectivesTo examine the association between electronic cigarette (e-cigarette) use and smoking cessation in the European Union (EU) in 2017 according to e-cigarette use frequency and smoking cessation duration.DesignCross-sectional survey of EU citizens, representative of the population (Special Eurobarometer 458). Weighted proportions (95% CI) and adjusted prevalence ratios (aPRs) were calculated.SettingEU.Participants13 057 EU citizens aged ≥15 years (6904 current and 6153 former smokers).ResultsCurrent daily e-cigarette use was reported by 2.4% (1.8%–3.1%) of current and 3.3% (2.5%–4.2%) of former smokers (p=0.002), while former daily use was reported by 5.6% (4.7%–6.8%) and 1.9% (1.3%–2.7%), respectively (p<0.001). More than half of all former smokers had quit for >10 years. Current daily e-cigarette use was rare among former smokers of >10 years (0.2%, 0.1%–0.6%) and was more prevalent in former smokers of ≤2 and 3–5 years (12.9%, 9.1%–17.9% and 9.0%, 5.8%–13.7%, respectively). Compared with never use, current daily e-cigarette use was associated with being a former smoker of ≤2 (aPR 4.96, 95% CI 3.57 to 6.90) and 3–5 years (aPR 3.20, 95% CI 2.10 to 4.87). Former daily e-cigarette use was associated with being a former smoker of ≤2 years (aPR 1.96, 95% CI 1.21 to 3.12). Current daily e-cigarette use was negatively associated with being a former smoker of 5–10 and >10 years.ConclusionsCurrent daily e-cigarette use in the EU in 2017 was rare among former smokers of >10 years and was positively associated with recent (≤5 years) smoking cessation. Former daily e-cigarette use was also positively associated with recent (≤2 years) smoking cessation.


Author(s):  
Spencer Kaspick ◽  
BCIT School of Health Sciences, Environmental Health ◽  
Helen Heacock

  Background: Electronic cigarettes are a widely-used, yet still emerging technology. As such, there is relatively little data regarding the reasons why people take up their use. Many claim to use them as a smoking-cessation method. Concern exists that experimentation in non-smokers may lead to nicotine addiction and subsequent smoking. The purpose of this study was to determine the primary reasons for the commencement of electronic cigarette use, and to suggest way in which these findings could affect current policies and regulations pertaining to electronic cigarettes. Methods: A survey examining electronic cigarette use was prepared. The survey contained questions respecting primary motivation for use, frequency of use, present and former smoking status as well as agreement with common perception about electronic cigarettes. Basic demographic information was also collected. The survey was posted to “www.reddit.com” and was accessible to users who used electronic cigarettes themselves via the “/r/electronic_cigarettes” sub-Reddit for a period of five days. Once responses were collected, Chi-square tests of independence were run to determine if any associations existed. Responses were also compared to previous studies of a similar nature to see if any similarities existed. Results: In total, 155 responses were received. The majority of the respondents were males (89.7%) between the ages of 19 and 28 (47.7%). 30.32% listed their occupation as “student”, and almost three-quarters of the respondents had some post-secondary experience. 78.1% of respondents were former smokers, and 61.3% identified their primary reason for electronic cigarette use as “to quit smoking.” Chi-squared tests for association between responses yielded statistically-significant associations between being a previous smoker and believing that electronic-cigarettes are healthier than conventional cigarettes, and between gender (specifically being male) and reasons for electronic cigarette use (specifically “to quit smoking”). However, the latter result was possibly skewed by a higher response rate from males as opposed to females. Conclusion: The high proportion of previous smokers among electronic cigarette users suggested that quitting smoking was the most common reason individuals take up electronic cigarette usage. It is therefore suggested that studies be done to determine if their use is less harmful than that of conventional cigarettes, and that existing legislation regarding their use in public be modified in light of this evidence. It is also suggested that they be given consideration as a legitimate means of smoking cessation.  


2020 ◽  
Vol 27 (1) ◽  
Author(s):  
A. J Arifin ◽  
L. C. McCracken ◽  
S. Nesbitt ◽  
A. Warner ◽  
R. E. Dinniwell ◽  
...  

Background Cigarette smoking is carcinogenic and has been linked to inferior treatment outcomes and complication rates in cancer patients. Here, we report the results of an 18-month pilot smoking cessation program that provided free nicotine replacement therapy (nrt).Methods In January 2017, the smoking cessation program at our institution began offering free nrt for actively cigarette-smoking patients with cancer. The cost of 4 weeks of nrt was covered by the program, and follow-up was provided by smoking cessation champions.Results From January 2017 to June 2018, 8095 patients with cancer were screened for cigarette use, of whom 1135 self-identified as current or recent smokers. Of those 1135 patients, 117 enrolled in the program and accepted a prescription for nrt. The rates of patient referral and patients attending a referral appointment were significantly higher in 2018–2018 than they had been in 2015–2016 (100% vs. 80.3%, p < 0.001, and 27.6% vs. 11.3%, p < 0.001, respectively). Median follow-up was 9.0 months (25%–75% interquartile range: 5.7–11.6 months). Of the patients who accepted nrt and who also had complete data (n = 71), 25 (35.2%) reported complete smoking cessation, and 32 (45.1%) reported only decreased cigarette smoking. On univariable analysis, no factors were significantly predictive of smoking cessation, although initial cigarette use (>10 vs. ≤10 initial cigarettes) was significantly predictive of smoking reduction (odds ratio: 5.04; 95% confidence interval: 1.46 to 17.45; p = 0.011).Conclusions This pilot study of free nrt demonstrated rates of referral and acceptance of nrt that were improved compared with historical rates, and most referred patients either decreased their use of cigarettes or quit entirely.


2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Karolien Adriaens ◽  
Eline Belmans ◽  
Dinska Van Gucht ◽  
Frank Baeyens

Abstract Background This interventional-cohort study tried to answer if people who smoke and choose an e-cigarette in the context of smoking cessation treatment by tobacco counselors in Flanders are achieving smoking abstinence and how they compare to clients who opt for commonly recommended (or no) aids (nicotine replacement therapy, smoking cessation medication). Methods Participants were recruited by tobacco counselors. They followed smoking cessation treatment (in group) for 2 months. At several times during treatment and 7 months after quit date, participants were asked to fill out questionnaires and to perform eCO measurements. Results One third of all participants (n = 244) achieved smoking abstinence 7 months after the quit date, with e-cigarette users having higher chances to be smoking abstinent at the final session compared to NRT users. Point prevalence abstinence rates across all follow-up measurements, however, as well as continuous and prolonged smoking abstinence, were similar in e-cigarette users and in clients having chosen a commonly recommended (or no) smoking cessation aid. No differences were obtained between smoking cessation aids with respect to product use and experiences. Conclusions People who smoke and choose e-cigarettes in the context of smoking cessation treatment by tobacco counselors show similar if not higher smoking cessation rates compared to those choosing other evidence-based (or no) smoking cessation aids.


Author(s):  
A. Kapan ◽  
S. Stefanac ◽  
I. Sandner ◽  
S. Haider ◽  
I. Grabovac ◽  
...  

The increasing popularity of electronic cigarettes in past decades has aroused public health concern. This study aims to review the literature on the prevalence of e-cigarette use among the general adult and young populations in Europe. We searched Medline and Google Scholar from September 2019, and included “prevalence of e-cigarettes”, “electronic cigarettes” or “e-cigarettes”, and “electronic nicotine delivery system” or “vaping”. The prevalence of current e-cigarette use ranged from 0.2% to 27%, ever-use ranged from 5.5% to 56.6% and daily use ranged from 1% to 2.9%. Current smokers of conventional cigarettes showed the highest prevalence for the use of e-cigarettes, ranging from 20.4% to 83.1%, followed by ex-smokers, with ranges from 7% to 15%. The following socio-demographic factors were associated with a higher chance of using e-cigarettes: male sex and younger age groups; results for economic status were inconclusive. In European countries, there is a higher prevalence of e-cigarette use among males, adolescents and young adults, smokers of conventional cigarettes, and former smokers.


Addiction ◽  
2017 ◽  
Vol 112 (9) ◽  
pp. 1620-1628 ◽  
Author(s):  
Anne Pasquereau ◽  
Romain Guignard ◽  
Raphaël Andler ◽  
Viêt Nguyen-Thanh

2015 ◽  
Vol 154 (1) ◽  
pp. 73-79 ◽  
Author(s):  
Nicholas McQueen ◽  
Erin J. Partington ◽  
Kathleen F. Harrington ◽  
Eben L. Rosenthal ◽  
William R. Carroll ◽  
...  

2019 ◽  
Vol 90 ◽  
pp. 85-91 ◽  
Author(s):  
Emmanuel Wiernik ◽  
Guillaume Airagnes ◽  
Emeline Lequy ◽  
Ramchandar Gomajee ◽  
Maria Melchior ◽  
...  

2020 ◽  
pp. 103985622095009
Author(s):  
Guna Kanniah ◽  
Shailesh Kumar ◽  
Soumil Prasad

Objective: Use of electronic cigarettes has increased across the world in the last decade with heavy investment from the tobacco industry targeting younger population through well-designed marketing campaigns portraying e-cigarettes as harmless, less addictive and effective in smoking cessation while delivering higher nicotine concentration. The safety profile of e-cigarettes is reviewed in this paper. Conclusions: The safety of e-cigarettes and the chemicals they contain have not been evaluated rigorously. Emerging data suggest e-cigarette use could do severe harm. People with serious mental illness, already the highest nicotine consumers, could be exploited by the tobacco industry.


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