Nicotine therapeutic benefits: Difference between revisions

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*Acknowledgement: This study was supported by the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health (K23HL136854 to Dr. Kalkhoran).  
*Acknowledgement: This study was supported by the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health (K23HL136854 to Dr. Kalkhoran).  
*Article: [https://medicalxpress.com/news/2019-07-daily-e-cigarette-smokers-regular-cigarettes.amp?__twitter_impression=true&fbclid=IwAR31bxC-WqHdBdIjXClI6fA9qOVsnPAP90sUGDAHHHJuW0xw-VANcuFsT1A Daily e-cigarette use may help smokers quit regular cigarettes]  
*Article: [https://medicalxpress.com/news/2019-07-daily-e-cigarette-smokers-regular-cigarettes.amp?__twitter_impression=true&fbclid=IwAR31bxC-WqHdBdIjXClI6fA9qOVsnPAP90sUGDAHHHJuW0xw-VANcuFsT1A Daily e-cigarette use may help smokers quit regular cigarettes]  
===2019: [https://onlinelibrary.wiley.com/doi/10.1111/add.14722 Indicators of cigarette smoking dependence and relapse in former smokers who vape compared with those who do not: findings from the 2016 International Tobacco Control Four Country Smoking and Vaping Survey]===
*Vapers were more likely than non-vapers to report: (1) having smoked within 5 minutes of waking; having smoked > 10 cigarettes/day; (2) perceiving themselves to be still very addicted to smoking and feeling extremely confident about staying quit.
*[https://onlinelibrary.wiley.com/doi/epdf/10.1111/add.14722 PDF Version]
*Citation: McNeill, A., Driezen, P., Hitchman, S. C., Cummings, K. M., Fong, G. T., and Borland, R. (2019) Indicators of cigarette smoking dependence and relapse in former smokers who vape compared with those who do not: findings from the 2016 International Tobacco Control Four Country Smoking and Vaping Survey. Addiction, 114( S1): 49– 60. doi: 10.1111/add.14722.
*This study was supported by grants from the US National Cancer Institute P01CA200512, the Canadian Institutes of Health Research (FDN - 148477), and by the National Health and Medical Research Council of Australia (APP1106451). G.T.F. was supported in part from a Senior Investigator Award from the Ontario Institute for Cancer Research.




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===2017: Cohort study of electronic cigarette use: effectiveness and safety at 24 months===
===2017: Cohort study of electronic cigarette use: effectiveness and safety at 24 months===
Of the e-cigarette users, 61.1% remained abstinent from tobacco (while 23.1% and 26.0% of tobacco-only smokers and dual users achieved tobacco abstinence).
Of the e-cigarette users, 61.1% remained abstinent from tobacco (while 23.1% and 26.0% of tobacco-only smokers and dual users achieved tobacco abstinence).
*[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5520273/pdf/tobaccocontrol-2015-052822.pdf PDF Version]
*Citation: Manzoli L, Flacco ME, Ferrante M, et al. Cohort study of electronic cigarette use: effectiveness and safety at 24 months. Tob Control. 2017;26(3):284-292. doi:10.1136/tobaccocontrol-2015-052822
*Acknowledgement: The first 2 years of the study were unfunded. The next 3 years of follow-up are going to be funded through crowdfunding (Kickstarter project titled ‘E-cigarette long-term efficacy & safety: a study to complete’).




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===2016: Patterns of Electronic Cigarette Use Among Adults in the United States===
===2016: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5896829/ Patterns of Electronic Cigarette Use Among Adults in the United States]===
Results: Current e-cigarette use is extremely low among never cigarette smokers (0.4%) and former smokers who quit cigarettes 4 or more years ago (0.8%). Although e-cigarette experimentation is most common among current cigarette smokers and young adults, daily use is highest among former smokers who quit in the past year (13.0%) and older adults. Compared to daily cigarette smokers, recently quit smokers were more than four times as likely to be daily users of e-cigarettes ( AOR : 4.33 [95% CI: 3.08–6.09]).
*Results: Current e-cigarette use is extremely low among never cigarette smokers (0.4%) and former smokers who quit cigarettes 4 or more years ago (0.8%). Although e-cigarette experimentation is most common among current cigarette smokers and young adults, daily use is highest among former smokers who quit in the past year (13.0%) and older adults. Compared to daily cigarette smokers, recently quit smokers were more than four times as likely to be daily users of e-cigarettes.
Conclusion: Extremely low e-cigarette use among never-smokers and longer term former smokers suggest that e-cigarettes neither promote widespread initiation nor relapse among adults. Recognition of the heterogeneity of smokers, including the time since quitting, is critical to draw accurate conclusions about patterns of e-cigarette use at the population level and its potential for public health benefit or harm.
*Conclusion: Extremely low e-cigarette use among never-smokers and longer term former smokers suggest that e-cigarettes neither promote widespread initiation nor relapse among adults. Recognition of the heterogeneity of smokers, including the time since quitting, is critical to draw accurate conclusions about patterns of e-cigarette use at the population level and its potential for public health benefit or harm.
*[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5896829/pdf/ntv237.pdf PDF Version]
*Citation: Delnevo CD, Giovenco DP, Steinberg MB, et al. Patterns of Electronic Cigarette Use Among Adults in the United States. Nicotine Tob Res. 2016;18(5):715-719. doi:10.1093/ntr/ntv237
*Acknowledgement: This research was supported in part by funding from the National Institutes of Health (R01CA19044 [CDD and MBS] and K01DA037950 [JLP])
   
   


===2016: Electronic cigarette use in the European Union: analysis of a representative sample of 27 460 Europeans from 28 countries===
===2016: [https://onlinelibrary.wiley.com/doi/abs/10.1111/add.13506 Electronic cigarette use in the European Union: analysis of a representative sample of 27 460 Europeans from 28 countries]===
E‐cigarette use in the European Union appears to be largely confined to current or former smokers, while current use and nicotine use by people who have never smoked is rare. More than one‐third of current e‐cigarette users polled reported smoking cessation and reduction.
*E‐cigarette use in the European Union appears to be largely confined to current or former smokers, while current use and nicotine use by people who have never smoked is rare. More than one‐third of current e‐cigarette users polled reported smoking cessation and reduction.
*[https://sci-hub.st/10.1111/add.13506 PDF Version]
*Citation: Farsalinos, K. E., Poulas, K., Voudris, V., & Le Houezec, J. (2016). Electronic cigarette use in the European Union: analysis of a representative sample of 27 460 Europeans from 28 countries. Addiction, 111(11), 2032–2040. doi:10.1111/add.13506
*Acknowledgement: No funding was provided for this study




===2015: E-Cigarettes and Smoking Cessation: Evidence from a Systematic Review and Meta-Analysis===
===2015: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4378973/ E-Cigarettes and Smoking Cessation: Evidence from a Systematic Review and Meta-Analysis]===
Conclusions: “This systematic review and meta-analyses assessed the findings of six studies which reported smoking cessation after using e-cigarettes. We found an association between nicotine-enriched e-cigarette use and smoking cessation, suggesting that the devices may be an effective alternative smoking cessation method. We also found that use of e-cigarettes was also associated with a reduction in the number of cigarettes used, suggesting they may also have a role in tobacco harm reduction programs. To our knowledge, this is the most comprehensive evidence to date on this issue, and while there are a number of important implications for further research, these findings provide timely information to inform regulatory strategies.”
*“This systematic review and meta-analyses assessed the findings of six studies which reported smoking cessation after using e-cigarettes. We found an association between nicotine-enriched e-cigarette use and smoking cessation, suggesting that the devices may be an effective alternative smoking cessation method. We also found that use of e-cigarettes was also associated with a reduction in the number of cigarettes used, suggesting they may also have a role in tobacco harm reduction programs. To our knowledge, this is the most comprehensive evidence to date on this issue, and while there are a number of important implications for further research, these findings provide timely information to inform regulatory strategies.”
*[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4378973/pdf/pone.0122544.pdf PDF Version]
*Citation: Rahman MA, Hann N, Wilson A, Mnatzaganian G, Worrall-Carter L. E-cigarettes and smoking cessation: evidence from a systematic review and meta-analysis. PLoS One. 2015;10(3):e0122544. Published 2015 Mar 30. doi:10.1371/journal.pone.0122544
*Acknowledgement: The authors have no support or funding to report.
   
   


===2015: A Longitudinal Study of Electronic Cigarette Use Among a Population-Based Sample of Adult Smokers: Association With Smoking Cessation and Motivation to Quit===
===2015: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4375383/ A Longitudinal Study of Electronic Cigarette Use Among a Population-Based Sample of Adult Smokers: Association With Smoking Cessation and Motivation to Quit]===
Results: At follow-up, 23% were intensive users, 29% intermittent users, 18% had used once or twice, and 30% had not tried e-cigarettes. Logistic regression controlling for demographics and tobacco dependence indicated that intensive users of e-cigarettes were 6 times more likely than non-users/triers to report that they quit smoking (OR: 6.07, 95% CI = 1.11, 33.2). No such relationship was seen for intermittent users. There was a negative association between intermittent e-cigarette use and 1 of 2 indicators of motivation to quit at follow-up.
*Results: At follow-up, 23% were intensive users, 29% intermittent users, 18% had used once or twice, and 30% had not tried e-cigarettes. Logistic regression controlling for demographics and tobacco dependence indicated that intensive users of e-cigarettes were 6 times more likely than non-users/triers to report that they quit smoking. Daily use of electronic cigarettes for at least 1 month is strongly associated with quitting smoking at follow-up. Further investigation of the underlying reasons for intensive versus intermittent use will help shed light on the mechanisms underlying the associations between e-cigarette use, motivation to quit, and smoking cessation.
Conclusion: Daily use of electronic cigarettes for at least 1 month is strongly associated with quitting smoking at follow-up. Further investigation of the underlying reasons for intensive versus intermittent use will help shed light on the mechanisms underlying the associations between e-cigarette use, motivation to quit, and smoking cessation.
*[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4375383/pdf/ntu200.pdf PDF Version]
*Citation: Biener L, Hargraves JL. A longitudinal study of electronic cigarette use among a population-based sample of adult smokers: association with smoking cessation and motivation to quit. Nicotine Tob Res. 2015;17(2):127-133. doi:10.1093/ntr/ntu200
*Acknowledgement: This work was supported by a grant from the US National Cancer Institute, grant #R01CA151384-03.




===2015: Associations Between E-Cigarette Type, Frequency of Use, and Quitting Smoking: Findings From a Longitudinal Online Panel Survey in Great Britain===  
===2015: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4580313/ Associations Between E-Cigarette Type, Frequency of Use, and Quitting Smoking: Findings From a Longitudinal Online Panel Survey in Great Britain]===  
Conclusion: Whether e-cigarette use is associated with quitting depends on type and frequency of use. Compared with respondents not using e-cigarettes, daily tank users were more likely, and non-daily cigalike users were less likely, to have quit. Tanks were more likely to be used by older respondents and respondents with lower education.  
*Whether e-cigarette use is associated with quitting depends on type and frequency of use. Compared with respondents not using e-cigarettes, daily tank users were more likely, and non-daily cigalike users were less likely, to have quit. Tanks were more likely to be used by older respondents and respondents with lower education.
*[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4580313/pdf/ntv078.pdf PDF Version]
*Citation: Hitchman SC, Brose LS, Brown J, Robson D, McNeill A. Associations Between E-Cigarette Type, Frequency of Use, and Quitting Smoking: Findings From a Longitudinal Online Panel Survey in Great Britain. Nicotine Tob Res. 2015;17(10):1187-1194. doi:10.1093/ntr/ntv078
*Acknowledgement: All authors are members of the UK Centre for Tobacco & Alcohol Studies, a UK Clinical Research Collaboration Public Health Research: Centre of Excellence whose work is supported by funding from the Medical Research Council, British Heart Foundation, Cancer Research UK, Economic and Social Research Council, and the National Institute for Health Research under the auspices of the UK Clinical Research Collaboration is gratefully acknowledged (MR/K023195/1). JB’s post is funded by a fellowship from the UK Society for the Study of Addiction.  
   
   


===2015: Electronic Cigarettes Efficacy and Safety at 12 Months: Cohort Study (PDF 14 pages)===  
===2015: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4464650/ Electronic Cigarettes Efficacy and Safety at 12 Months: Cohort Study]===  
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...
*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...
*[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4464650/pdf/pone.0129443.pdf PDF Version]
*Citation: Manzoli L, Flacco ME, Fiore M, et al. Electronic Cigarettes Efficacy and Safety at 12 Months: Cohort Study. PLoS One. 2015;10(6):e0129443. Published 2015 Jun 10. doi:10.1371/journal.pone.0129443
*Acknowledgement: The authors have no support or funding to report.




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===2014: Effectiveness of the Electronic Cigarette: An Eight-Week Flemish Study with Six-Month Follow-up on Smoking Reduction, Craving and Experienced Benefits and Complaints===
===2014: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4245610/ Effectiveness of the Electronic Cigarette: An Eight-Week Flemish Study with Six-Month Follow-up on Smoking Reduction, Craving and Experienced Benefits and Complaints]===
When people, ready to switch to an e-cig, are severely restricted in terms of accessibility of nicotine-containing e-liquids, the success of e-cigs may be endangered. For the e-cig to be and remain successful, it is important that people have easy access to nicotine containing e-liquids.
*When people, ready to switch to an e-cig, are severely restricted in terms of accessibility of nicotine-containing e-liquids, the success of e-cigs may be endangered. For the e-cig to be and remain successful, it is important that people have easy access to nicotine containing e-liquids.
Conclusion: “In a series of controlled lab sessions with e-cig-naïve tobacco smokers, second-generation e-cigs were shown to be immediately and highly effective in reducing abstinence-induced cigarette craving and withdrawal symptoms, while not resulting in increases in eCO. Ad libitum use of e-cigs—in between and until six months after the lab sessions—resulted in remarkable reductions in or (biologically confirmed) complete abstinence from tobacco smoking in almost half of the participants who had no intention to quit smoking. [highlighting added] Eight months after the start of the study 21% of all participants were completely abstinent from tobacco cigarettes. Similar reduction/cessation rates were obtained with guided versus non-guided switching to e-cigs. Part of the observed efficacy of e-cigs in this study may be related to the fact that they allowed to maintain relatively high blood nicotine levels and showed an excellent experienced benefits/complaints ratio, especially in comparison with continued tobacco smoking”...
*“In a series of controlled lab sessions with e-cig-naïve tobacco smokers, second-generation e-cigs were shown to be immediately and highly effective in reducing abstinence-induced cigarette craving and withdrawal symptoms, while not resulting in increases in eCO. Ad libitum use of e-cigs—in between and until six months after the lab sessions—resulted in remarkable reductions in or (biologically confirmed) complete abstinence from tobacco smoking in almost half of the participants who had no intention to quit smoking. Eight months after the start of the study 21% of all participants were completely abstinent from tobacco cigarettes. Similar reduction/cessation rates were obtained with guided versus non-guided switching to e-cigs. Part of the observed efficacy of e-cigs in this study may be related to the fact that they allowed to maintain relatively high blood nicotine levels and showed an excellent experienced benefits/complaints ratio, especially in comparison with continued tobacco smoking”...
E-cigarette is an attractive long-term alternative and safer source of nicotine to conventional cigarette. Since their invention in 2003, there has been constant innovation and development of more efficient and appealing products. Here we show for the first time that second generation PVs can substantially decrease cigarette consumption without causing significant side effects in smokers not intending to quit. Moreover, overall participants’ perception and acceptance of these products was very good, in particular for those who quit or reduced smoking. Compared to our earlier work with first generation “cig-alikes”, technical problems and difficulties in use familiarization with second generation PVs were negligible. Improved products reliability and attractiveness might have contributed to the very low number of study failures and lost to follow-up and high success rates thus confirming the notion that these products are attractive substitutes for conventional cigarettes. Although large and carefully conducted RCTs will be required to confirm these preliminary encouraging observations, the notion that second generation PVs can substantially decrease cigarette consumption in smokers not intending to quit should be taken into consideration by regulatory authorities seeking to adopt proportional measures for the vapour category  
*E-cigarette is an attractive long-term alternative and safer source of nicotine to conventional cigarette. Since their invention in 2003, there has been constant innovation and development of more efficient and appealing products. Here we show for the first time that second generation PVs can substantially decrease cigarette consumption without causing significant side effects in smokers not intending to quit. Moreover, overall participants’ perception and acceptance of these products was very good, in particular for those who quit or reduced smoking. Compared to our earlier work with first generation “cig-alikes”, technical problems and difficulties in use familiarization with second generation PVs were negligible. Improved products reliability and attractiveness might have contributed to the very low number of study failures and lost to follow-up and high success rates thus confirming the notion that these products are attractive substitutes for conventional cigarettes. Although large and carefully conducted RCTs will be required to confirm these preliminary encouraging observations, the notion that second generation PVs can substantially decrease cigarette consumption in smokers not intending to quit should be taken into consideration by regulatory authorities seeking to adopt proportional measures for the vapour category
*[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4245610/pdf/ijerph-11-11220.pdf PDF Version]
*Citation: Adriaens K, Van Gucht D, Declerck P, Baeyens F. Effectiveness of the electronic cigarette: An eight-week Flemish study with six-month follow-up on smoking reduction, craving and experienced benefits and complaints. Int J Environ Res Public Health. 2014;11(11):11220-11248. Published 2014 Oct 29. doi:10.3390/ijerph111111220
*Acknowledgement: No external funding for this study was obtained.