Steinberg Michael B, Zimmermann Mia Hanos, Delnevo Cristine D, Lewis M Jane, Shukla Parth, Coups Elliot J, Foulds Jonathan
Rutgers-Robert Wood Johnson Medical School, Division of General Internal Medicine, 125 Paterson Street, Suite 2300, New Brunswick, NJ, 08903, USA,
J Gen Intern Med. 2014 Nov;29(11):1444-50. doi: 10.1007/s11606-014-2889-7. Epub 2014 May 15.
Novel nicotine delivery products, such as electronic cigarettes (e-cigarettes), have dramatically grown in popularity despite limited data on safety and benefit. In contrast, the similar U.S. Food and Drug Administration (FDA)-approved nicotine inhaler is rarely utilized by smokers. Understanding this paradox could be helpful to determine the potential for e-cigarettes as an alternative to tobacco smoking.
To compare the e-cigarette with the nicotine inhaler in terms of perceived benefits, harms, appeal, and role in assisting with smoking cessation.
A cross-over trial was conducted from 2012 to 2013 PARTICIPANTS/INTERVENTIONS: Forty-one current smokers age 18 and older used the e-cigarette and nicotine inhaler each for 3 days, in random order, with a washout period in between. Thirty-eight participants provided data on product use, perceptions, and experiences.
The Modified Cigarette Evaluation Questionnaire (mCEQ) measured satisfaction, reward, and aversion. Subjects were also asked about each product's helpfulness, similarity to cigarettes, acceptability, image, and effectiveness in quitting smoking. Cigarette use was also recorded during the product-use periods.
The e-cigarette had a higher total satisfaction score (13.9 vs. 6.8 [p < 0.001]; range for responses 3-21) and higher reward score (15.8 vs. 8.7 [p < 0.001]; range for responses 5-35) than the inhaler. The e-cigarette received higher ratings for helpfulness, acceptability, and "coolness." More subjects would use the e-cigarette to make a quit attempt (76 %) than the inhaler (24 %) (p < 0.001). Eighteen percent (7/38) of subjects abstained from smoking during the 3-day periods using the e-cigarette vs. 10 % (4/38) using the inhaler (p = 0.18).
The e-cigarette was more acceptable, provided more satisfaction, and had higher perceived benefit than the inhaler during this trial. E-cigarettes have the potential to be important nicotine delivery products owing to their high acceptance and perceived benefit, but more data are needed to evaluate their actual efficacy and safety. Providers should be aware of these issues, as patients will increasingly inquire about them.
新型尼古丁递送产品，如电子烟，尽管关于其安全性和益处的数据有限，但已迅速流行起来。相比之下，美国食品药品监督管理局（FDA）批准的类似尼古丁吸入器却很少被吸烟者使用。理解这一矛盾现象可能有助于确定电子烟作为吸烟替代品的潜力。
比较电子烟和尼古丁吸入器在感知益处、危害、吸引力以及辅助戒烟方面的作用。
2012年至2013年进行了一项交叉试验。参与者/干预措施：41名18岁及以上的当前吸烟者，随机顺序分别使用电子烟和尼古丁吸入器各3天，中间有洗脱期。38名参与者提供了关于产品使用、认知和体验的数据。
改良香烟评估问卷（mCEQ）测量满意度、奖赏感和厌恶感。还询问了受试者每种产品的帮助程度、与香烟的相似性、可接受性、形象以及戒烟效果。在产品使用期间也记录了香烟使用情况。
电子烟的总满意度得分（13.9对6.8 [p < 0.001]；回答范围3 - 21）和奖赏得分（15.8对8.7 [p < 0.001]；回答范围5 - 35）高于吸入器。电子烟在帮助程度、可接受性和“酷感”方面获得更高评分。与吸入器（24%）相比，更多受试者（76%）会使用电子烟尝试戒烟（p < 0.001）。在使用电子烟的3天期间，18%（7/38）的受试者戒烟，而使用吸入器的为10%（4/38）（p = 0.18）。
在本次试验中，电子烟比吸入器更易接受，提供了更多满意度，且感知益处更高。由于其高接受度和感知益处，电子烟有可能成为重要的尼古丁递送产品，但需要更多数据来评估其实际疗效和安全性。医疗服务提供者应了解这些问题，因为患者会越来越多地询问相关情况。
