Total number of library items: 243

Research Library Search


Published Year: 2024.    Publication Type: Journal Article
Publication Title: New England Journal of Medicine.

Electronic Nicotine-Delivery Systems for Smoking Cessation

Authors: Reto Auer, M.D., Anna Schoeni, Ph.D., Jean-Paul Humair, M.D., M.P.H, Isabelle Jacot-Sadowski, M.D., Ivan Berlin, M.D., Ph.D., Mirah J. Stuber, M.D., Moa Lina Haller, M.D., Rodrigo Casagrande Tango, M.D., M.P.H., Anja Frei, Ph.D., Alexandra Strassmann, Ph.D., Philip Bruggmann, M.D., Florent Baty, Ph.D., Martin Brutsche, M.D., Ph.D., Kali Tal, Ph.D., Stéphanie Baggio, Ph.D., Julian Jakob, M.D., Nicolas Sambiagio, Ph.D., Nancy B. Hopf, Ph.D., Martin Feller, M.D., Nicolas Rodondi, M.D., Aurélie Berthet, Ph.D.

ISBN/ISSN:
0028-4793, 1533-4406.    DOI: 10.1056/NEJMoa2308815.
Website/Url: http://www.nejm.org/doi/10.1056/NEJMoa2308815

Abstract:

Background
Electronic nicotine-delivery systems — also called e-cigarettes — are used by some tobacco smokers to assist with quitting. Evidence regarding the efficacy and safety of these systems is needed.

Methods
In this open-label, controlled trial, we randomly assigned adults who were smoking at least five tobacco cigarettes per day and who wanted to set a quit date to an intervention group, which received free e-cigarettes and e-liquids, standard-of-care smoking-cessation counseling, and optional (not free) nicotine-replacement therapy, or to a control group, which received standard counseling and a voucher, which they could use for any purpose, including nicotine-replacement therapy. The primary outcome was biochemically validated, continuous abstinence from smoking at 6 months. Secondary outcomes included participant-reported abstinence from tobacco and from any nicotine (including smoking, e-cigarettes, and nicotine-replacement therapy) at 6 months, respiratory symptoms, and serious adverse events.

Results
A total of 1246 participants underwent randomization; 622 participants were assigned to the intervention group, and 624 to the control group. The percentage of participants with validated continuous abstinence from tobacco smoking was 28.9% in the intervention group and 16.3% in the control group (relative risk, 1.77; 95% confidence interval, 1.43 to 2.20). The percentage of participants who abstained from smoking in the 7 days before the 6-month visit was 59.6% in the intervention group and 38.5% in the control group, but the percentage who abstained from any nicotine use was 20.1% in the intervention group and 33.7% in the control group. Serious adverse events occurred in 25 participants (4.0%) in the intervention group and in 31 (5.0%) in the control group; adverse events occurred in 272 participants (43.7%) and 229 participants (36.7%), respectively.

Conclusions
The addition of e-cigarettes to standard smoking-cessation counseling resulted in greater abstinence from tobacco use among smokers than smoking-cessation counseling alone. (Funded by the Swiss National Science Foundation and others; ESTxENDS ClinicalTrials.gov number, NCT03589989. opens in new tab.)

Tag: Cessation, Comparison, Adverse Effects
Key: FKMHA3CQ


Published Year: 2024.    Publication Type: Journal Article
Publication Title: JAMA Network Open.

Trends in Harm Perceptions of E-Cigarettes vs Cigarettes Among Adults Who Smoke in England, 2014-2023

Authors: Sarah E Jackson, Harry Tattan-Birch, Katherine East, Sharon Cox, Lion Shahab, Jamie Brown

ISBN/ISSN:
2574-3805.    DOI: 10.1001/jamanetworkopen.2024.0582.
Website/Url: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2815561

Abstract:

Importance
Electronic cigarettes (e-cigarettes) are less harmful to users than combustible cigarettes. However, public health and media reporting have often overstated the potential risks of e-cigarettes, and inaccurate perceptions of the harms of vaping relative to smoking are pervasive.

Objective
To examine time trends in harm perceptions of e-cigarettes compared with combustible cigarettes among adults who smoke.

Design, Setting, and Participants
This nationally representative monthly cross-sectional survey study was conducted from November 2014 to June 2023 in England. Participants were adults who currently smoke.

Main Outcomes and Measures
Participants were asked whether they thought e-cigarettes were less harmful, equally harmful, or more harmful than cigarettes, or did not know, with the proportion responding less harmful (vs all other responses) as the primary outcome. Logistic regression was used to test associations between survey wave and participants’ perceptions of the harms of e-cigarettes.

Results
Data were collected from 28 393 adults who smoke (mean [SD] age, 43.5 [17.3] years; 13 253 [46.7%] women). In November 2014, 44.4% (95% CI, 42.0%-46.8%) thought e-cigarettes were less harmful than cigarettes, 30.3% (95% CI, 28.2%-32.6%) thought e-cigarettes were equally harmful, 10.8% (95% CI, 9.4%-12.3%) thought they were more harmful, and 14.5% (95% CI, 12.9%-16.4%) did not know. However, by June 2023, the proportion who thought e-cigarettes were less harmful had decreased by 40% (prevalence ratio, 0.60; 95% CI, 0.55-0.66), and the proportion who thought e-cigarettes were more harmful had more than doubled (prevalence ratio, 2.16; 95% CI, 1.84-2.54). Changes over time were nonlinear: late 2019 saw a sharp decline in the proportion who thought e-cigarettes were less harmful and increases in the proportions who thought they were equally or more harmful. These changes were short-lived, returning to pre-2019 levels by the end of 2020. However, perceptions worsened again from 2021 up to the end of the study period: the proportion who thought e-cigarettes were more harmful increased to a new high, and the proportion who thought e-cigarettes were less harmful decreased to levels comparable to those in late 2019. As a result, in June 2023, the perception that e-cigarettes were equally as harmful as cigarettes was the most commonly held view among adults who smoke (33.7%; 95% CI, 31.4%-36.1%), with roughly similar proportions perceiving e-cigarettes to be less (26.7%; 95% CI, 24.6%-28.9%) and more (23.3%; 95% CI, 21.1%-25.7%) harmful.

Conclusions and Relevance
This survey study of adults who smoke in England found that harm perceptions of e-cigarettes have worsened substantially over the last decade, such that most adults who smoked in 2023 believed e-cigarettes to be at least as harmful as cigarettes. The timing of the 2 most notable changes in harm perceptions coincided with the e-cigarette, or vaping product, use-associated lung injury outbreak in 2019 and the recent increase in youth vaping in England since 2021.

Tag: Perceptions, Population, Communication
Key: EAVKRSR5


Published Year: 2024.    Publication Type: Journal Article
Publication Title: Emergency Medicine Journal.

Cessation of Smoking Trial in the Emergency Department (COSTED): a multicentre randomised controlled trial

Authors: Ian Pope, Lucy V Clark, Allan Clark, Emma Ward, Pippa Belderson, Susan Stirling, Steve Parrott, Jinshuo Li, Tim Coats, Linda Bauld, Richard Holland, Sarah Gentry, Sanjay Agrawal, Benjamin Michael Bloom, Adrian A Boyle, Alasdair J Gray, M Geraint Morris, Jonathan Livingstone-Banks, Caitlin Notley

ISBN/ISSN:
.    DOI: 10.1136/emermed-2023-213824.
Website/Url: http://emj.bmj.com/content/early/2024/03/01/emermed-2023-213824.abstract

Abstract:

Background
Supporting people to quit smoking is one of the most powerful interventions to improve health. The Emergency Department (ED) represents a potentially valuable opportunity to deliver a smoking cessation intervention if it is sufficiently resourced. The objective of this trial was to determine whether an opportunistic ED-based smoking cessation intervention can help people to quit smoking.
Methods
In this multicentre, parallel-group, randomised controlled superiority trial conducted between January and August 2022, adults who smoked daily and attended one of six UK EDs were randomised to intervention (brief advice, e-cigarette starter kit and referral to stop smoking services) or control (written information on stop smoking services). The primary outcome was biochemically validated abstinence at 6 months.
Results
An intention-to-treat analysis included 972 of 1443 people screened for inclusion (484 in the intervention group, 488 in the control group). Of 975 participants randomised, 3 were subsequently excluded, 17 withdrew and 287 were lost to follow-up. The 6-month biochemically-verified abstinence rate was 7.2% in the intervention group and 4.1% in the control group (relative risk 1.76; 95% CI 1.03 to 3.01; p=0.038). Self-reported 7-day abstinence at 6 months was 23.3% in the intervention group and 12.9% in the control group (relative risk 1.80; 95% CI 1.36 to 2.38; p<0.001). No serious adverse events related to taking part in the trial were reported.
Conclusions
An opportunistic smoking cessation intervention comprising brief advice, an e-cigarette starter kit and referral to stop smoking services is effective for sustained smoking abstinence with few reported adverse events.Trial registration number NCT04854616.Data are available upon reasonable request. The protocol, consent form, statistical analysis plan, medical ethics committee approvals, training materials and other relevant study materials are available online at https://osf.io/8hbne/. Deidentified participant data will be made publicly available within 3 months at the above address.

Tag: Cessation, Comparison
Key: VK6HHT6P


Published Year: 2023.    Publication Type: Journal Article
Publication Title: SSRN Electronic Journal.

E-cigarette Flavor Restrictions’ Effects on Tobacco Product Sales

Authors: Friedman, Abigail, Liber, Alex C., Crippen, Alyssa, Pesko, Michael

ISBN/ISSN:
1556-5068.    DOI: 10.2139/ssrn.4586701.
Website/Url: https://www.ssrn.com/abstract=4586701

Abstract:

Over 375 US localities and 7 states have adopted permanent restrictions on sales of flavored electronic nicotine delivery systems (“ENDS”). These policies’ effects on combustible cigarette use (“smoking”), a more lethal habit, remain unclear. Matching new flavor policy data to retail sales data, we find a tradeoff of 15 additional cigarettes for every 1 less 0.7 mL ENDS pod sold due to ENDS flavor restrictions. Further, cigarette sales increase even among brands disproportionately used by underage youth. Thus, any public health benefits of reducing ENDS use via flavor restrictions may be offset by public health costs from increased cigarette sales.

Tag: Flavours, Regulations
Key: YG2BG2HL


Published Year: 2023.    Publication Type: Journal Article
Publication Title: Internal and Emergency Medicine.

Clinical testing of the cardiovascular effects of e-cigarette substitution for smoking: a living systematic review

Authors: La Rosa, Giusy, Polosa, Riccardo, Qureshi, Maria, Vernooij, Robin

ISBN/ISSN:
1828-0447, 1970-9366.    DOI: 10.1007/s11739-022-03161-z.
Website/Url: https://link.springer.com/10.1007/s11739-022-03161-z

Abstract:

Abstract Some persons who smoke have substituted e-cigarettes for tobacco cigarettes, either completely or partially. What effect does this have on cardiovascular functioning? We conducted a living systematic review on human clinical studies measuring the cardiovascular effects of e-cigarette substitution for smoking. The Scopus, PubMed, and CENTRAL Cochrane Library databases were searched on January 31 and April 29, 2021. Three secondary searches and a grey literature search were conducted. Included study designs were randomized controlled trials, quasi-experimental clinical trials, and cohort studies. Risk of bias and study quality were evaluated with the JBI Critical Appraisal tools and the Oxford Catalogue of Bias . The systematic review covered 25 studies comprising 1810 participants who smoked. Twenty studies were rated at high risk of bias, and five as some concerns. A tabular synthesis by direction of effect was conducted due to heterogeneity in the data. Nearly two-thirds of the test analyses indicated that e-cigarette use had no significance difference compared with tobacco cigarettes on heart rate, blood pressure, and in other cardiovascular tests. In two studies, participants with hypertension experienced a clinically relevant reduction in systolic blood pressure after 1 year of e-cigarette use. E-cigarette substitution incurs no additional cardiovascular risks, and some possible benefits may be obtained, but the evidence is of low to very low certainty. An update search on May 30, 2022 retrieved five studies that did not alter our conclusion. Registration PROSPERO #CRD42021239094.

Tag: Meta-analysis, Systematic Review, Cardiovascular
Key: INRCBEN2


Published Year: 2023.    Publication Type: Journal Article
Publication Title: Nicotine & Tobacco Research.

Do Tobacco Companies Have an Incentive to Promote “Harm Reduction” Products?: The Role of Competition

Authors: Cummings, K Michael, Douglas, Clifford E, Meza, Rafael, Sanchez-Romero, Luz Maria, Liber, Alex, Sweanor, David, Thirlway, Frances, Levy, David T

ISBN/ISSN:
1469-994X.    DOI: 10.1093/ntr/ntad014.
Website/Url: https://academic.oup.com/ntr/advance-article/doi/10.1093/ntr/ntad014/7000361

Abstract:

Abstract
Background
Some cigarette companies have started to talk about replacing cigarettes with less harmful alternatives, which might include nicotine vaping products (NVPs), heated tobacco products (HTPs) and oral nicotine delivery products (ONDPs). We consider market competition as a primary driver of whether cigarette companies follow through on their stated intentions.

Methods
We focus on the behavior of cigarette companies in the US. We compare competition in the pre- and post-2012 time periods, analyze the impact of the growth in NVPs on smoking prevalence and cigarette company profits, and examine the potential future role of competition.

Results
Since 2006, consumers have broadened their use of non-combustible nicotine delivery products (NCNDPs) to include, inter alia, NVPs, HTPs and ONDPs. US cigarette companies have acquired major stakes in each of these product categories which corresponds to a period of rapidly declining adult smoking prevalence, especially among younger adults (ages 18-24 years). The shifting dynamics of the nicotine product marketplace are also reflected in cigarette company stock prices. While cigarette companies are likely to promote HTPs and ONDPs over NVPs, their incentives will be directly related to competition from independent firms, which in turn will depend on government regulation.

Conclusions
While cigarette companies will back alternatives to combusted tobacco when threatened by competition, the prospects for their lasting conversion to NCNDPs will depend on the extent of such competition, which will be influenced by government regulation of tobacco products.

Implications
Regulations that limit competition from independent firms while also protecting cigarette company profits risk slowing or even reversing recent declines in smoking, especially among youth and young adults. Regulations that reduce the appeal and addictiveness of combusted tobacco products, such as higher cigarette taxes or a reduced nicotine standard, will encourage smokers to quit and/or switch to less harmful non-combusted forms of tobacco. The regulation of non-combustible nicotine delivery products and cigarettes should be proportionate to their relative risks, so that smokers have incentives to switch from combustibles to safer alternatives, and cigarette companies have incentives to promote safer products.

Tag: Industry
Key: M4NQC9HQ


Published Year: 2023.    Publication Type: Journal Article
Publication Title: Nicotine & Tobacco Research.

Adoption of E-Cigarettes among Older Adults who Smoke to Reduce Harm and Narrow Age-Related Disparities: An Application of the Health Belief Model

Authors: McClernon, F Joseph, Cornacchione Ross, Jennifer, Denlinger-Apte, Rachel L, Rubenstein, Dana

ISBN/ISSN:
1469-994X.    DOI: 10.1093/ntr/ntad016.
Website/Url: https://academic.oup.com/ntr/advance-article/doi/10.1093/ntr/ntad016/7005641

Abstract:

Extract
Tobacco Burden Among Older Adults
While the prevalence of combusted cigarette (CC) smoking among all other age groups of U.S. adults decreased between 2005 and 2020, the prevalence for those age ≥55 years remained stagnant.1,2 Indeed, 2021 estimates from the National Health Interview Survey (NHIS) suggest current smoking is as prevalent among adults ages ≥65 years (9.4%; 95% Confidence interval = 8.4, 10.5) as it is among adults ages 18–34 years (9.6%; 95% CI = 8.4, 11.0).3 Smoking in older adults carries burdensome health consequences: Among adults ≥65 years who report current cigarette smoking, 25.7% report smoking-related cancer and 46.9% report another smoking-related chronic disease.4 Furthermore, according to 2017 NHIS data, past-year quit attempts are less prevalent among adults 45–64 years (49.6%) and ≥65 years (47.2%) compared to adults 25–44 years (59.8%) as is the prevalence of quit interest (53.7%, 68.7%, and 72.7%, respectively).5 Older adults struggle with smoking cessation: Only 5% of adults ≥65 years who smoke successfully quit in the past year.4 The tobacco industry has played a role in these rates; they aggressively marketed “light” and “low-tar” cigarettes towards older adults while discouraging quitting and providing cigarettes at senior clubs and nursing homes.6

Tag: Perceptions
Key: RPLW99G9


Published Year: 2023.    Publication Type: Journal Article
Publication Title: International Journal of Gynecology & Obstetrics.

Association between maternal e_cigarette use during pregnancy and low gestational weight gain

Authors: Munlyn, Ambra L., Griffiths, Malkijah E., Duong, Peter H., Moe, Aye A., Liu, Lufeiya, Thomas, Marjorie A., Wen, Xiaozhong

ISBN/ISSN:
0020-7292, 1879-3479.    DOI: 10.1002/ijgo.14672.
Website/Url: https://onlinelibrary.wiley.com/doi/10.1002/ijgo.14672

Abstract:

Objective: To evaluate the risk of low gestational weight gain (GWG) in women who use electronic cigarettes (e-cigarettes), combustible cigarettes, or both e-cigarettes and combustible cigarettes (dual use) during pregnancy. Methods: We conducted a secondary analysis of the data from 176 882 singleton pregnancies in the 2016-2020 US Pregnancy Risk Assessment Monitoring System (PRAMS). Postpartum women self-reported their use of e-cigarettes and/or cigarettes during the last 3 months of pregnancy. Low GWG was defined as the total GWG less than 12.7 kg, less than 11.3 kg, less than 6.8 kg, and less than 5.0 kg (<28, <25, <15, and < 11 lb) for women with underweight, normal weight, overweight, and obesity, respectively. We used multivariable logistic regression to estimate the odds ratios (ORs) of low GWG, adjusting for confounders. Results: In this national sample, 921 (weighted percentage, 0.5%) of women were e-cigarette users and 1308 (0.7%) were dual users during late pregnancy. Compared with non-users during late pregnancy (40 090, 22.1%), cigarette users (4499, 28.0%) and dual users (427, 26.0%) had a higher risk of low GWG, but e-cigarette users had a similar risk (237, 22.1%). Adjustment for sociodemographic and pregnancy confounders moderately attenuated these associations: confounder-adjusted ORs 1.26 (95% confidence interval [CI] 1.18-1.35) for cigarette users, 1.18 (95% CI 0.96-1.44) for dual users, and 0.99 (95% CI 0.78-1.27) for e-cigarette users. Conclusions: Unlike combustible cigarette use, e-cigarette use during late pregnancy does not appear to be a risk factor for low GWG.

Tag: Pregnancy, Comparison, Cessation, Dual Use
Key: 3ZHL5DRS