Richard J. Wang and Sudhamayi Bhadriraju were initially postdoctoral fellows in the Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of California San Francisco; Richard J. Wang subsequently joined the faculty as an assistant professor of medicine, and Sudhamayi Bhadriraju joined the pulmonary medicine staff at the Kaiser Permanente Medical Center, Redwood City, CA. Stanton A. Glantz was professor of medicine and director of the Center for Tobacco Control Research and Education at the University of California San Francisco.
Am J Public Health. 2021 Feb;111(2):230-246. doi: 10.2105/AJPH.2020.305999. Epub 2020 Dec 22.
To determine the association between e-cigarette use and smoking cessation. We searched PubMed, Web of Science Core Collection, and EMBASE and computed the association of e-cigarette use with quitting cigarettes using random effects meta-analyses. We identified 64 papers (55 observational studies and 9 randomized clinical trials [RCTs]). In observational studies of all adult smokers (odds ratio [OR] = 0.947; 95% confidence interval [CI] = 0.772, 1.160) and smokers motivated to quit smoking (OR = 0.851; 95% CI = 0.684, 1.057), e-cigarette consumer product use was not associated with quitting. Daily e-cigarette use was associated with more quitting (OR = 1.529; 95% CI = 1.158, 2.019) and less-than-daily use was associated with less quitting (OR = 0.514; 95% CI = 0.402, 0.665). The RCTs that compared quitting among smokers who were provided e-cigarettes to smokers with conventional therapy found e-cigarette use was associated with more quitting (relative risk = 1.555; 95% CI = 1.173, 2.061). As consumer products, in observational studies, e-cigarettes were not associated with increased smoking cessation in the adult population. In RCTs, provision of free e-cigarettes as a therapeutic intervention was associated with increased smoking cessation. E-cigarettes should not be approved as consumer products but may warrant consideration as a prescription therapy.
为了确定电子烟使用与戒烟之间的关联，我们检索了 PubMed、Web of Science Core Collection 和 EMBASE，并使用随机效应荟萃分析计算了电子烟使用与戒烟的关联。我们确定了 64 篇论文（55 项观察性研究和 9 项随机临床试验[RCT]）。在所有成年吸烟者（优势比[OR]=0.947；95%置信区间[CI]=0.772，1.160）和有戒烟意愿的吸烟者（OR=0.851；95%CI=0.684，1.057）的观察性研究中，电子烟消费品的使用与戒烟无关。电子烟的日常使用与戒烟的关联性更大（OR=1.529；95%CI=1.158，2.019），而非日常使用与戒烟的关联性更小（OR=0.514；95%CI=0.402，0.665）。比较给予电子烟和常规治疗的吸烟者戒烟率的 RCT 发现，电子烟的使用与戒烟率的提高有关（相对风险=1.555；95%CI=1.173，2.061）。作为消费品，在观察性研究中，电子烟并未增加成年人的戒烟率。在 RCT 中，作为一种治疗干预措施提供免费电子烟与戒烟率的提高有关。电子烟不应被批准为消费品，但可能需要作为处方治疗进行考虑。
