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Electronic Cigarettes Efficacy and Safety at 12 Months: Cohort Study.

Manzoli L, Flacco ME, Fiore M, La Vecchia C, Marzuillo C, Gualano MR, Liguori G, Cicolini G, Capasso L, D'Amario C, Boccia S, Siliquini R, Ricciardi W, Villari P - PLoS ONE (2015)

Bottom Line: Adjusting for potential confounders, tobacco smoking abstinence or cessation remained significantly more likely among e-smokers (adjusted OR 5.19; 95% CI: 3.35-8.02), whereas adding e-cigarettes to tobacco smoking did not enhance the likelihood of quitting tobacco and did not reduce tobacco cigarette consumption.Non significant differences were found in self-reported serious adverse events (eleven overall).NCT01785537.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine and Aging Sciences, University of Chieti, via dei Vestini 5, 66013, Chieti, Italy; Local Health Unit of Pescara, Via Renato Paolini 47, 65100, Pescara, Italy; "University G. d'Annunzio" Foundation, Via Colle dell'Ara, 66013, Chieti, Italy; Regional Healthcare Agency of Abruzzo, Via Attilio Monti 9, 65127, Pescara, Italy.

ABSTRACT

Objective: To evaluate the safety and efficacy as a tool of smoking cessation of electronic cigarettes (e-cigarettes), directly comparing users of e-cigarettes only, smokers of tobacco cigarettes only, and smokers of both.

Design: Prospective cohort study. Final results are expected in 2019, but given the urgency of data to support policies on electronic smoking, we report the results of the 12-month follow-up.

Data sources: Direct contact and structured questionnaires by phone or via internet.

Methods: Adults (30-75 years) were included if they were smokers of ≥1 tobacco cigarette/day (tobacco smokers), users of any type of e-cigarettes, inhaling ≥50 puffs weekly (e-smokers), or smokers of both tobacco and e-cigarettes (dual smokers). Carbon monoxide levels were tested in a sample of those declaring tobacco smoking abstinence.

Main outcome measures: Sustained smoking abstinence from tobacco smoking at 12 months, reduction in the number of tobacco cigarettes smoked daily.

Data synthesis: We used linear and logistic regression, with region as cluster unit.

Results: Follow-up data were available for 236 e-smokers, 491 tobacco smokers, and 232 dual smokers (overall response rate 70.8%). All e-smokers were tobacco ex-smokers. At 12 months, 61.9% of the e-smokers were still abstinent from tobacco smoking; 20.6% of the tobacco smokers and 22.0% of the dual smokers achieved tobacco abstinence. Adjusting for potential confounders, tobacco smoking abstinence or cessation remained significantly more likely among e-smokers (adjusted OR 5.19; 95% CI: 3.35-8.02), whereas adding e-cigarettes to tobacco smoking did not enhance the likelihood of quitting tobacco and did not reduce tobacco cigarette consumption. E-smokers showed a minimal but significantly higher increase in self-rated health than other smokers. Non significant differences were found in self-reported serious adverse events (eleven overall).

Conclusions: Adding e-cigarettes to tobacco smoking did not facilitate smoking cessation or reduction. If e-cigarette safety will be confirmed, however, the use of e-cigarettes alone may facilitate quitters remaining so.

Registration number: NCT01785537.

No MeSH data available.


Related in: MedlinePlus

Smoking status after twelve months of follow-up, by smoking status at baseline.
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pone.0129443.g002: Smoking status after twelve months of follow-up, by smoking status at baseline.

Mentions: After twelve months, 61.9% of the e-smokers were still abstinent from tobacco smoking; 20.6% of the tobacco smokers and 22.0% of the dual smokers achieved tobacco abstinence (Table 2). More than half (53.5%) of dual smokers abandoned e-cigarettes and continued to smoke only tobacco cigarettes (Fig 2). The proportion of subjects who quit all types of smoking (tobacco and e-cigarettes) did not significantly differ by baseline smoking status: 15.7%, 13.7% and 11.6% among electronic, tobacco and dual smokers, respectively (p>0.05). If analyzed with an Intention-To-Treat approach, which is however problematic given the large amount of switchers in the study, the above proportions of all-smoking quitters were 10.8%, 8.7% and 9.5%, respectively (all p>0.05). Only 41 (8.8%) e-smokers used nicotine-free e-cigarettes, and they were similar to nicotine e-smokers on both the rates of tobacco smoking relapse (43.9% vs 40.3%, respectively) and the rates of all-smoking cessation (14.6% vs 13.8%, respectively; all p>0.05).


Electronic Cigarettes Efficacy and Safety at 12 Months: Cohort Study.

Manzoli L, Flacco ME, Fiore M, La Vecchia C, Marzuillo C, Gualano MR, Liguori G, Cicolini G, Capasso L, D'Amario C, Boccia S, Siliquini R, Ricciardi W, Villari P - PLoS ONE (2015)

Smoking status after twelve months of follow-up, by smoking status at baseline.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4464650&req=5

pone.0129443.g002: Smoking status after twelve months of follow-up, by smoking status at baseline.
Mentions: After twelve months, 61.9% of the e-smokers were still abstinent from tobacco smoking; 20.6% of the tobacco smokers and 22.0% of the dual smokers achieved tobacco abstinence (Table 2). More than half (53.5%) of dual smokers abandoned e-cigarettes and continued to smoke only tobacco cigarettes (Fig 2). The proportion of subjects who quit all types of smoking (tobacco and e-cigarettes) did not significantly differ by baseline smoking status: 15.7%, 13.7% and 11.6% among electronic, tobacco and dual smokers, respectively (p>0.05). If analyzed with an Intention-To-Treat approach, which is however problematic given the large amount of switchers in the study, the above proportions of all-smoking quitters were 10.8%, 8.7% and 9.5%, respectively (all p>0.05). Only 41 (8.8%) e-smokers used nicotine-free e-cigarettes, and they were similar to nicotine e-smokers on both the rates of tobacco smoking relapse (43.9% vs 40.3%, respectively) and the rates of all-smoking cessation (14.6% vs 13.8%, respectively; all p>0.05).

Bottom Line: Adjusting for potential confounders, tobacco smoking abstinence or cessation remained significantly more likely among e-smokers (adjusted OR 5.19; 95% CI: 3.35-8.02), whereas adding e-cigarettes to tobacco smoking did not enhance the likelihood of quitting tobacco and did not reduce tobacco cigarette consumption.Non significant differences were found in self-reported serious adverse events (eleven overall).NCT01785537.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine and Aging Sciences, University of Chieti, via dei Vestini 5, 66013, Chieti, Italy; Local Health Unit of Pescara, Via Renato Paolini 47, 65100, Pescara, Italy; "University G. d'Annunzio" Foundation, Via Colle dell'Ara, 66013, Chieti, Italy; Regional Healthcare Agency of Abruzzo, Via Attilio Monti 9, 65127, Pescara, Italy.

ABSTRACT

Objective: To evaluate the safety and efficacy as a tool of smoking cessation of electronic cigarettes (e-cigarettes), directly comparing users of e-cigarettes only, smokers of tobacco cigarettes only, and smokers of both.

Design: Prospective cohort study. Final results are expected in 2019, but given the urgency of data to support policies on electronic smoking, we report the results of the 12-month follow-up.

Data sources: Direct contact and structured questionnaires by phone or via internet.

Methods: Adults (30-75 years) were included if they were smokers of ≥1 tobacco cigarette/day (tobacco smokers), users of any type of e-cigarettes, inhaling ≥50 puffs weekly (e-smokers), or smokers of both tobacco and e-cigarettes (dual smokers). Carbon monoxide levels were tested in a sample of those declaring tobacco smoking abstinence.

Main outcome measures: Sustained smoking abstinence from tobacco smoking at 12 months, reduction in the number of tobacco cigarettes smoked daily.

Data synthesis: We used linear and logistic regression, with region as cluster unit.

Results: Follow-up data were available for 236 e-smokers, 491 tobacco smokers, and 232 dual smokers (overall response rate 70.8%). All e-smokers were tobacco ex-smokers. At 12 months, 61.9% of the e-smokers were still abstinent from tobacco smoking; 20.6% of the tobacco smokers and 22.0% of the dual smokers achieved tobacco abstinence. Adjusting for potential confounders, tobacco smoking abstinence or cessation remained significantly more likely among e-smokers (adjusted OR 5.19; 95% CI: 3.35-8.02), whereas adding e-cigarettes to tobacco smoking did not enhance the likelihood of quitting tobacco and did not reduce tobacco cigarette consumption. E-smokers showed a minimal but significantly higher increase in self-rated health than other smokers. Non significant differences were found in self-reported serious adverse events (eleven overall).

Conclusions: Adding e-cigarettes to tobacco smoking did not facilitate smoking cessation or reduction. If e-cigarette safety will be confirmed, however, the use of e-cigarettes alone may facilitate quitters remaining so.

Registration number: NCT01785537.

No MeSH data available.


Related in: MedlinePlus