E-cigarettes and smoking cessation in real-world and clinical settings: a systematic review and meta-analysis.
E-cigarettes and smoking cessation in real-world and clinical settings: a systematic review and meta-analysis.
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DOI：
10.1016/s2213-2600(15)00521-4
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发表时间：
2016-02
期刊：
影响因子：
--
通讯作者：
Glantz SA
中科院分区：
文献类型：
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作者：
Kalkhoran S;Glantz SA
吸烟者越来越多地使用电子烟有许多原因，包括试图戒除可燃香烟和在禁止吸烟的地方使用尼古丁。我们的目标是评估成年吸烟者中电子烟的使用与戒烟之间的联系，无论他们使用电子烟的动机如何。PubMed和Web of Science在2015年4月27日至2015年6月17日期间被搜索。提取的数据包括研究地点、设计、人口、电子烟使用的定义和流行率、对照组(如果适用)、香烟消费量、尼古丁依赖程度、其他混杂因素、戒烟定义和戒烟几率。主要终点是戒烟。使用随机效应荟萃分析评估了使用电子烟的吸烟者与不使用电子烟的吸烟者的戒烟几率。使用改良的Acrobat-NRSI工具和Cochrane Risk of Bias工具评估偏倚。这项荟萃分析已在Propero注册(编号为CRD42015020382)。38项研究(已确定的577项研究)纳入系统评价；所有20项对照研究(15项队列研究、3项横断面研究和2项临床试验)均纳入随机效应荟萃分析和敏感性分析。使用电子烟的人戒烟的几率比不使用电子烟的人低28%(优势比[OR]0·72，95%CI 0·57-0·91)。与只对戒烟感兴趣的吸烟者的研究(OR为0.63，95%CI为0.45-0.86vs0.86，0.60-1.23；p=0.94)相比，在所有吸烟者的研究中，电子烟的使用与戒烟的关系没有显著差异(无论是否有戒烟兴趣)。其他研究特征(设计、人群、对照组、对照变量、暴露评估时间、戒烟的生化验证和电子烟使用的定义)也与总体效应大小无关(所有病例的p≥均为0.77)。根据目前的使用情况，电子烟与吸烟者戒烟的数量显著减少有关。
Smokers increasingly use e-cigarettes for many reasons, including attempts to quit combustible cigarettes and to use nicotine where smoking is prohibited. We aimed to assess the association between e-cigarette use and cigarette smoking cessation among adult cigarette smokers, irrespective of their motivation for using e-cigarettes. PubMed and Web of Science were searched between April 27, 2015, and June 17, 2015. Data extracted included study location, design, population, definition and prevalence of e-cigarette use, comparison group (if applicable), cigarette consumption, level of nicotine dependence, other confounders, definition of quitting smoking, and odds of quitting smoking. The primary endpoint was cigarette smoking cessation. Odds of smoking cessation among smokers using e-cigarettes compared with smokers not using e-cigarettes were assessed using a random effects meta-analysis. A modification of the ACROBAT-NRSI tool and the Cochrane Risk of Bias Tool were used to assess bias. This meta-analysis is registered with PROSPERO (number CRD42015020382). 38 studies (of 577 studies identified) were included in the systematic review; all 20 studies with control groups (15 cohort studies, three cross-sectional studies, and two clinical trials) were included in random effects meta-analysis and sensitivity analyses. Odds of quitting cigarettes were 28% lower in those who used e-cigarettes compared with those who did not use e-cigarettes (odds ratio [OR] 0·72, 95% CI 0·57–0·91). Association of e-cigarette use with quitting did not significantly differ among studies of all smokers using e-cigarettes (irrespective of interest in quitting cigarettes) compared with studies of only smokers interested in cigarette cessation (OR 0·63, 95% CI 0·45–0·86 vs 0·86, 0·60–1·23; p=0·94). Other study characteristics (design, population, comparison group, control variables, time of exposure assessment, biochemical verification of abstinence, and definition of e-cigarette use) were also not associated with the overall effect size (p≥0·77 in all cases). As currently being used, e-cigarettes are associated with significantly less quitting among smokers.