Electronic cigarette use and smoking cessation in cohort studies and randomized trials: A systematic review and meta-analysis.
Electronic cigarette use and smoking cessation in cohort studies and randomized trials: A systematic review and meta-analysis.
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在队列研究和随机试验中的电子香烟使用和戒烟：系统评价和荟萃分析。
DOI：
10.18332/tpc/142320
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发表时间：
2021
影响因子：
1.8
通讯作者：
Adermark L
中科院分区：
文献类型：
--
作者：
Hedman L;Galanti MR;Ryk L;Gilljam H;Adermark L
本系统综述和荟萃分析的目的是在队列研究和随机对照试验（RCT）中评估电子烟使用与随后戒烟之间的关系。系统文献检索于2019年11月11日完成，检索工具包括EMBASE、Cochrane Library、Scopus、PubMed Health、NICE证据检索、PROSPERO、CRD、PsycInfo和PubMed（包括Medline）。纳入标准为：报告实证结果；纵向观察设计，随访至少3个月；包括一般人口样本；并允许对电子烟使用者和非使用者进行比较。被评为具有高偏倚风险的研究被排除在外。遵循PRISMA描述的程序，并使用GRADE对证据质量进行评级。本综述纳入了来自26项队列研究的28篇纵向同行评议出版物，以及来自7项随机对照试验的8篇评估电子烟使用与戒烟之间关系的出版物。一项基于39147名队列研究参与者的随机效应荟萃分析显示，基线电子烟使用者与基线非使用者戒烟的合并未调整比值比（OR）为0.97 (95% CI: 0.67-1.40)，而调整后的OR为0.90 （95% CI: 0.63-1.27）。在随机对照试验中，戒烟的合并优势比为1.78 （95% CI: 1.41-2.25）。队列研究的证据等级非常低，随机对照试验的证据等级也很低。我们没有发现电子烟使用与戒烟之间存在关联的高质量证据。尽管与队列研究相比，随机对照试验倾向于支持电子烟使用与戒烟之间更积极的联系，但证据的分级一直很低。
The aim of this systematic review and meta-analysis was to assess the association between e-cigarette use and subsequent smoking cessation in cohort studies and randomized controlled trials (RCT). A systematic literature search was finalized 11 November 2019 using EMBASE, Cochrane Library, Scopus, PubMed Health, NICE evidence search, PROSPERO, CRD, PsycInfo, and PubMed including Medline. Inclusion criteria were: reporting empirical results; longitudinal observational design with a minimum of 3 months of follow-up; including general population samples; and allowing for comparison between users and non-users of e-cigarettes. Studies rated as having high risk of bias were excluded. The procedures described by PRISMA were followed, and the quality of evidence was rated using GRADE. Twenty-eight longitudinal, peer-reviewed publications from 26 cohort studies, and eight publications from seven RCTs assessing the association between e-cigarette use and smoking cessation were included in this review. A random-effects meta-analysis based on 39147 participants in cohort studies showed a pooled unadjusted odds ratio (OR) for smoking cessation among baseline e-cigarette users compared with baseline non-users of 0.97 (95% CI: 0.67–1.40), while the adjusted OR was 0.90 (95% CI: 0.63–1.27). The pooled odds ratio for smoking cessation in RCTs was 1.78 (95% CI: 1.41–2.25). The evidence for cohort studies was graded as very low and for RCTs as low. We did not find quality evidence for an association between e-cigarette use and smoking cessation. Although RCTs tended to support a more positive association between e-cigarette use and smoking cessation than the cohort studies, the grading of evidence was consistently low.
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