Zawertailo Laurie, Kouzoukas Erika, Fougere Chantal, Dragonetti Rosa, Veldhuizen Scott, Selby Peter
Nicotine Dependence Service, Addictions Program, Centre for Addiction and Mental Health, Toronto, ON, Canada.
Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada.
Prev Med Rep. 2023 Aug 19;35:102372. doi: 10.1016/j.pmedr.2023.102372. eCollection 2023 Oct.
Individuals seek help to stop their use of e-cigarettes from their healthcare practitioners. However, there is a paucity of published work addressing e-cigarette cessation methods empirically, and what evidence that is available is weak. Therefore, we developed an expert informed clinical resource to guide practitioners helping their clients quit using e-cigarettes. We conducted a modified Delphi process between September and December 2021 to reach consensus on clinical recommendations for e-cigarette cessation. Expert and Peer Panel members (n = 28) voted and provided feedback on the recommendations through three rounds of structured surveys, a discussion board, and one intermediate survey. The penultimate knowledge products underwent usability testing and were finalized based on user feedback. The Expert Panel maintained a 100% response rate for rounds 1 and 2 and 96% for round 3; the Peer Panel achieved a 100% response rate for all three rounds of the modified Delphi process. Consensus was reach on 24 recommendations and 2 statements spanning eight domains: severity and dependence; general approaches; treatment approaches; dual use; pharmacotherapy strategies; behavioural therapy strategies; harm reduction; and relapse prevention. Two additional 'no agreement' statements that did not reach consensus are included in the guidance resource. The recommendations were also contextualized for the following groups: adults; youth; people who are pregnant, breastfeeding and/or chestfeeding; and people with mental illness and/or substance use issues. The recommendations listed in the resource provide general clinical guidance on e-cigarette cessation to assist healthcare practitioners in the treatment planning process.
个人会向医疗保健从业者寻求帮助以停止使用电子烟。然而，实证研究电子烟戒烟方法的已发表作品很少，现有的证据也很薄弱。因此，我们开发了一种基于专家意见的临床资源，以指导从业者帮助他们的客户戒掉电子烟。我们在2021年9月至12月期间进行了一个改进的德尔菲过程，以就电子烟戒烟的临床建议达成共识。专家和同行小组成员（n = 28）通过三轮结构化调查、一个讨论板和一次中间调查对这些建议进行投票并提供反馈。倒数第二个知识产品进行了可用性测试，并根据用户反馈最终确定。专家小组在第1轮和第2轮的回复率为100%，第3轮为96%；同行小组在改进的德尔菲过程的所有三轮中回复率均达到100%。就涵盖八个领域的24项建议和2项声明达成了共识：严重程度和依赖性；一般方法；治疗方法；同时使用；药物治疗策略；行为治疗策略；减少危害；以及预防复发。指导资源中还包括另外两项未达成共识的“无共识”声明。这些建议也针对以下群体进行了背景化：成年人；青少年；孕妇、哺乳期妇女和/或正在进行母乳喂养的人；以及患有精神疾病和/或有物质使用问题的人。该资源中列出的建议为电子烟戒烟提供了一般临床指导，以协助医疗保健从业者进行治疗规划过程。
