Agaku Israel, Egbe Catherine O, Ayo-Yusuf Olalekan
School of Health System and Public Health, University of Pretoria, Pretoria, Gauteng, South Africa
Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, Massachusetts, USA.
Tob Control. 2022 May;31(3):464-472. doi: 10.1136/tobaccocontrol-2020-056102. Epub 2021 Jan 15.
The South African Medicines Control Council classifies e-cigarettes as Schedule 3 substances and requires them to be dispensed only within pharmacies. e-Cigarettes are however ubiquitous and are marketed as cessation aids. We investigated the relationship between e-cigarette use and smoking cessation among South African adult smokers.
Data came from a 2018 web survey of South African adults aged ≥18 years (n=18 208). Cessation-related attitudes and behaviours were assessed. Using multivariable logistic regression, we measured the association between e-cigarette use and cessation behaviours among ever-established combustible tobacco smokers who tried to quit.
Among current combustible smokers, more e-cigarette ever versus never users believed e-cigarettes could assist smokers to completely quit (35.5% vs 20.4%) or cut down (51.7% vs 26.5%) (all p<0.05). Among ever-established smokers, the odds of sustained quitting at the 12-month mark were lower among those who used e-cigarettes once off/rarely (adjusted OR (AOR)=0.20, 95% CI=0.16-0.24), former e-cigarette users (AOR=0.30, 95% CI=0.24-0.38) and current e-cigarette users (AOR=0.23, 95% CI=0.18-0.29), compared with never e-cigarette users. Among ever-established smokers who had ever tried to quit, 53.6% relapsed into smoking after quitting for any length of time. The odds of relapsing among ever-established smokers who had made a quit attempt and had a quit intention were higher among those who used e-cigarettes once off/rarely (AOR=2.66; 95% CI=2.31-3.08), former e-cigarette users (AOR=1.41; 95% CI=1.18-1.69) and current e-cigarette users (AOR=1.85; 95% CI=1.55-2.22) than never e-cigarette users.
e-Cigarette use depressed long-term cessation. These findings can inform restrictions on unsubstantiated claims of e-cigarettes as cessation aids within South Africa.
南非药品管制委员会将电子烟归类为附表3物质，并要求仅在药店销售。然而，电子烟随处可见，并被作为戒烟辅助工具进行营销。我们调查了南非成年吸烟者中电子烟使用与戒烟之间的关系。
数据来自2018年对年龄≥18岁的南非成年人进行的网络调查（n = 18208）。评估了与戒烟相关的态度和行为。使用多变量逻辑回归，我们测量了曾经尝试戒烟的已确立使用可燃烟草的吸烟者中电子烟使用与戒烟行为之间的关联。
在当前可燃烟草吸烟者中，曾经使用过电子烟的人与从未使用过电子烟的人相比，更多人认为电子烟可以帮助吸烟者完全戒烟（35.5%对20.4%）或减少吸烟量（51.7%对26.5%）（所有p<0.05）。在已确立吸烟习惯的吸烟者中，一次性/很少使用电子烟的人、曾经使用过电子烟的人和当前使用电子烟的人在12个月时持续戒烟的几率低于从未使用过电子烟的人（调整后的比值比（AOR）=0.20，95%置信区间=0.16 - 0.24）、曾经使用过电子烟的人（AOR = 0.30，95%置信区间=0.24 - 0.38）和当前使用电子烟的人（AOR = 0.23，95%置信区间=0.18 - 0.29）。在曾经尝试戒烟的已确立吸烟习惯的吸烟者中，53.6%在戒烟任何时长后复吸。在曾经尝试戒烟且有戒烟意愿的已确立吸烟习惯的吸烟者中，一次性/很少使用电子烟的人、曾经使用过电子烟的人和当前使用电子烟的人复吸的几率高于从未使用过电子烟的人（AOR = 2.66；95%置信区间=2.31 - 3.08）、曾经使用过电子烟的人（AOR =
1.41；95%置信区间=
1.18 - 1.69）和当前使用电子烟的人（AOR = 1.85；95%置信区间=1.55 - 2.22）。
使用电子烟会降低长期戒烟成功率。这些发现可为南非限制电子烟作为戒烟辅助工具的无根据宣称提供参考。
