Centre for Youth Substance Abuse Research, The University of Queensland, Australia.
Centre for Youth Substance Abuse Research, The University of Queensland, Australia.
Addict Behav. 2021 Aug;119:106912. doi: 10.1016/j.addbeh.2021.106912. Epub 2021 Mar 15.
E-cigarettes, or nicotine vaping products, are potential smoking cessation aids that provide both nicotine and behavioural substitution for combustible cigarette smoking. This review aims to compare the effectiveness of nicotine e-cigarettes for smoking cessation with licensed nicotine replacement therapies (NRT) and nicotine-free based control conditions by using network meta-analysis (NMA).
We searched PubMed, Web of Science and PsycINFO for randomised controlled trials (RCTs) that allocated individuals to use nicotine e-cigarettes, compared to those that used licensed NRT (e.g., nicotine patches, nicotine gums, etc), or a nicotine-free control condition such as receiving placebo (nicotine-free) e-cigarettes or usual care. We only included studies of healthy individuals who smoked. Furthermore, we identified the latest Cochrane review on NRT and searched NRT trials that were published in similar periods as the e-cigarette trials we identified. NMA was conducted to compare the effect of e-cigarettes on cessation relative to NRT and control condition. Cochrane risk-of-bias tool for randomized trials Version 2 was used to access study bias.
For the e-cigarette trials, our initial search identified 4,717 studies and we included 7 trials for NMA after removal of duplicates, record screening and assessment of eligibility (Total N = 5,674). For NRT trials, our initial search identified 1,014 studies and we included 9 trials that satisfied our inclusion criteria (Total N = 6,080). Results from NMA indicated that participants assigned to use nicotine e-cigarettes were more likely to remain abstinent from smoking than those in the control condition (pooled Risk Ratio (RR) = 2.08, 97.5% CI = [1.39, 3.15]) and those who were assigned to use NRT (pooled RR = 1.49, 97.5% CI = [1.04, 2.14]. There was a moderate heterogeneity between studies (I = 42%). Most of the e-cigarette trials has moderate or high risk of bias.
Smokers assigned to use nicotine e-cigarettes were more likely to remain abstinent from smoking than those assigned to use licensed NRT, and both were more effective than usual care or placebo conditions. More high quality studies are required to ascertain the effect of e-cigarette on smoking cessation due to risk of bias in the included studies.
电子烟，或尼古丁蒸气产品，是潜在的戒烟辅助工具，为可燃香烟吸烟提供尼古丁和行为替代。本综述旨在通过网络荟萃分析（NMA）比较尼古丁电子烟戒烟与许可尼古丁替代疗法（NRT）和无尼古丁对照条件的效果。
我们检索了 PubMed、Web of Science 和 PsycINFO，以查找将个体分配使用尼古丁电子烟的随机对照试验（RCT），并将其与使用许可的 NRT（如尼古丁贴片、尼古丁口香糖等）或无尼古丁对照条件（如使用无尼古丁电子烟或常规护理）进行比较。我们仅纳入了吸烟的健康个体的研究。此外，我们确定了关于 NRT 的最新 Cochrane 综述，并搜索了在我们确定的电子烟试验类似时期发表的 NRT 试验。进行 NMA 以比较电子烟相对于 NRT 和对照条件对戒烟的影响。使用 Cochrane 随机试验风险偏倚工具版本 2 来评估研究偏倚。
对于电子烟试验，我们最初的搜索确定了 4717 项研究，在去除重复项、记录筛选和评估合格性后，我们纳入了 7 项用于 NMA 的试验（总 N=5674）。对于 NRT 试验，我们最初的搜索确定了 1014 项研究，纳入了 9 项符合纳入标准的试验（总 N=6080）。NMA 的结果表明，与对照组相比（汇总风险比（RR）=2.08，97.5%置信区间[1.39,3.15]）和使用 NRT 的参与者相比（汇总 RR=1.49，97.5%置信区间[1.04,2.14]），被分配使用尼古丁电子烟的参与者更有可能保持戒烟状态。研究之间存在中度异质性（I=42%）。大多数电子烟试验具有中度或高度偏倚风险。
与被分配使用许可的 NRT 的吸烟者相比，被分配使用尼古丁电子烟的吸烟者更有可能保持戒烟状态，而且两者都比常规护理或安慰剂条件更有效。由于纳入研究的偏倚风险，需要更多高质量的研究来确定电子烟对戒烟的效果。
