O'Leary Renée, La Rosa Giusy Rita Maria, Polosa Riccardo
Center of Excellence for the Acceleration of Harm Reduction, University of Catania, Italy.
Department of Clinical and Experimental Medicine, University of Catania, Italy.
Drug Alcohol Depend. 2025 Jan 1;266:112520. doi: 10.1016/j.drugalcdep.2024.112520. Epub 2024 Dec 3.
This umbrella review identified the current high-quality systematic reviews on e-cigarettes as a smoking cessation aid. What is the comparative effectiveness of e-cigarettes compared to other cessation treatments or approaches? We also investigated the systematic reviews for reporting biases.
This umbrella review was based on the Methods for Overviews of Reviews (MOoR) framework and the Preferred Reporting Items for Overviews of Reviews (PRIOR). The search was conducted in six databases and grey literature searches in four sources, plus four secondary searches. A Vote Counting Direction of Effect was selected for the analysis method because of high heterogeneity among the primary studies and the potential overweighting of data from two primary studies.
Sixteen systematic reviews were retrieved. Eight with an AMSTAR2 rating of moderate or high confidence were included, encompassing 24 randomized controlled trials. The analysis found that in 8 of 11 comparisons, e-cigarettes were more effective, and 3 of 11 comparisons reported no statistically significant difference. No reviews concluded that e-cigarettes were significantly less effective than any treatment or no treatment.
Our analysis indicated that e-cigarettes are more effective than other treatments for smoking cessation. For ENDS compared solely to NRT, the evidence was mixed and still favored the effectiveness of ENDS. In any case, the success rates for cessation with ENDS was 10 % - 12 % at 6 months to one year, and the effect of relapse has not been sufficiently studied. New treatments and approaches are urgently needed.
PROSPERO CRD42023406165; International Registered Report Identifier (IRRID): PRR1-10.2196/47711.
本伞状综述确定了当前关于电子烟作为戒烟辅助工具的高质量系统评价。与其他戒烟治疗方法或途径相比，电子烟的相对有效性如何？我们还调查了系统评价中的报告偏倚情况。
本伞状综述基于综述概述方法（MOoR）框架和综述概述的首选报告项目（PRIOR）。在六个数据库中进行了检索，并在四个来源进行了灰色文献检索，另外还进行了四次二次检索。由于原始研究之间存在高度异质性以及两项原始研究的数据可能被过度加权，因此选择了效应方向的投票计数法作为分析方法。
检索到16项系统评价。纳入了8项AMSTAR2评分为中等或高可信度的评价，涵盖24项随机对照试验。分析发现，在11项比较中有8项显示电子烟更有效，11项比较中有3项报告无统计学显著差异。没有评价得出电子烟比任何治疗方法或不治疗显著效果更差的结论。
我们的分析表明，电子烟在戒烟方面比其他治疗方法更有效。仅将电子烟与尼古丁替代疗法（NRT）相比，证据不一，但仍支持电子烟的有效性。无论如何，使用电子烟在6个月至1年时的戒烟成功率为10% - 12%，而复吸的影响尚未得到充分研究。迫切需要新的治疗方法和途径。
PROSPERO CRD42023406165；国际注册报告标识符（IRRID）：PRR1-10.2196/47711
