Heiden Brendan T, Baker Timothy B, Smock Nina, Pham Giang, Chen Jingling, Bierut Laura J, Chen Li-Shiun
Division of Cardiothoracic Surgery, Department of Surgery, Washington University in St Louis School of Medicine, St Louis, Missouri, USA
Division of Public Health Sciences, Department of Surgery, Washington University in St Louis School of Medicine, St Louis, Missouri, USA.
Thorax. 2022 Jul 20. doi: 10.1136/thorax-2022-218680.
The utility of electronic cigarettes ('e-cigarettes') as a smoking cessation adjunct remains unclear. Similarly, it is unclear if formal tobacco treatment (pharmacotherapy and/or behavioural support) augments smoking cessation in individuals who use both cigarettes and e-cigarettes.
We performed a longitudinal cohort study of adult outpatients evaluated in our tertiary care medical centre (6/2018-6/2020). E-cigarette use, smoking status and formal tobacco treatment (deterrent pharmacotherapy and/or behavioural support) were assessed in 6-month blocks (eg, cohort 1 (C1)=6/2018-12/2018, C2=1/2019-6/2019 and so on) using our electronic health record. We assessed the relationship between e-cigarette use (either with or without formal tobacco treatment) and point prevalence of smoking cessation at 6 and 12 months.
111 823 unique patients were included in the study. The prevalence of dual use of cigarettes and e-cigarettes increased significantly over the study period (C1=0.8%; C2=1.1%; C3=1.8%; C4=2.3%; p<0.001). The prevalence of smoking cessation at 12 months was higher among e-cigarette users (20.8%) compared with non-users (16.8%) (risk difference, 4.0% (95% CI 2.5% to 5.5%); adjusted relative risk (aRR) 1.354, 95% CI 1.252 to 1.464, p<0.0001). Further, among dual users of cigarettes and e-cigarettes, the prevalence of smoking cessation at 12 months was higher among individuals who received tobacco treatment (29.1%) compared with individuals who did not receive tobacco treatment (19.6%) (risk difference, 9.5% (95% CI, 4.6% to 14.4%); aRR 1.238, 95% CI 1.071 to 1.432, p=0.004).
These results suggest that dual users of cigarettes and e-cigarettes benefit from formal tobacco treatment. Clinicians should consider offering formal tobacco treatment to such patients, though future trials are needed.
电子烟作为戒烟辅助工具的效用仍不明确。同样，对于同时使用香烟和电子烟的个体，正规烟草治疗（药物治疗和/或行为支持）是否能增强戒烟效果也不清楚。
我们对在我们三级医疗中心接受评估的成年门诊患者进行了一项纵向队列研究（2018年6月至2020年6月）。使用我们的电子健康记录，以6个月为一个时间段（例如，队列1（C1）=2018年6月至2018年12月，C2=2019年1月至2019年6月等）评估电子烟使用情况、吸烟状况和正规烟草治疗（威慑性药物治疗和/或行为支持）。我们评估了电子烟使用（无论是否接受正规烟草治疗）与6个月和12个月时戒烟的点患病率之间的关系。
111823名独特患者纳入研究。在研究期间，香烟和电子烟同时使用的患病率显著增加（C1=0.8%；C2=1.1%；C3=1.8%；C4=2.3%；p<0.001）。与非电子烟使用者（16.8%）相比，电子烟使用者在12个月时的戒烟患病率更高（20.8%）（风险差异，4.0%（95%CI 2.5%至5.5%）；调整后相对风险（aRR）1.354，95%CI 1.252至1.464，p<0.0001）。此外，在香烟和电子烟同时使用者中，接受烟草治疗的个体在12个月时的戒烟患病率（29.1%）高于未接受烟草治疗的个体（19.6%）（风险差异，9.5%（95%CI，4.6%至14.4%）；aRR 1.238，95%CI 1.071至1.432，p=0.004）。
这些结果表明，香烟和电子烟同时使用者可从正规烟草治疗中获益。临床医生应考虑为这类患者提供正规烟草治疗，不过还需要未来的试验。
