Is switching to e-cigarettes effective help for smokers who want to quit?
For adults who wish to quit smoking, nicotine delivery via e-cigarettes, plus counseling, may be more effective than other means of nicotine replacement for long-term smoking cessation. There was no report of the percentage of patients who maintained e-cigarette use while remaining abstinent from smoking.
Plan de l'etude:
Meta-analysis (randomized controlled trials)
The investigators searched 3 databases, including Cochrane CENTRAL, and identified 5 randomized controlled trials studying a total of 3253 people who smoked and wished to quit. The studies were limited to those published in English or French. Two authors independently selected articles for inclusion and extracted the data. Two studies compared nicotine replacement with e-cigarettes plus counseling, nicotine-free e-cigarettes plus counseling, and counseling alone. three studies compared nicotine replacement with e-cigarettes plus counseling with either nicotine-free e-cigarettes or any conventional (ie, non-e-cigarette) smoking cessation therapy (eg, a patch). There were no studies of any comparison with varenicline or bupropion. Biochemically confirmed abstinence (via expired carbon monoxide levels) at 6 months (4 studies) or 1 year (1 study) was more likely with nicotine e-cigarette replacement than conventional therapy (relative risk 1.77; 95% CI 1.29 - 2.44), translating into a number needed to treat of 19 (10 - 51). Nicotine e-cigarettes were also more effective than nicotine-free e-cigarettes (relative risk = 1.56, 95% CI 1.13 to 2.15). There was no heterogeneity for these results among the studies. Study quality was generally high.
Allen F. Shaughnessy, PharmD, MMedEd
Professor of Family Medicine