Myth: Alternative nicotine products don't help people stop smoking: Difference between revisions

 
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='''No Intention of Quitting Smoking (Accidental Quitters)'''=
='''No Intention of Quitting Smoking (Accidental Quitters)'''=
===2024: [https://academic.oup.com/ntr/advance-article-abstract/doi/10.1093/ntr/ntae047/7623369 Using pod based e-cigarettes and nicotine pouches to reduce harm for adults with low socioeconomic status who smoke: A pilot randomized controlled trial]===
*This study provides novel evidence that e-cigarettes and nicotine pouches can be a harm reduction tool for individuals with lower SES who smoke and are not willing to quit smoking, contributing to reducing tobacco-related disparities in this population.


===2023: [https://link.springer.com/article/10.1007/s00213-023-06401-y Smoking reduction using electronic nicotine delivery systems in combination with nicotine skin patches]===
===2023: [https://link.springer.com/article/10.1007/s00213-023-06401-y Smoking reduction using electronic nicotine delivery systems in combination with nicotine skin patches]===
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*Article about the study: [https://www.revyuh.com/top-news/featured/e-cigarettes-may-help-you-quit-smoking-even-if-you-dont-want-to/ E-cigarettes may help you quit smoking, even if you don’t want to]
*Article about the study: [https://www.revyuh.com/top-news/featured/e-cigarettes-may-help-you-quit-smoking-even-if-you-dont-want-to/ E-cigarettes may help you quit smoking, even if you don’t want to]
*Press Release: [https://www.roswellpark.org/newsroom/202112-daily-vaping-dramatically-ups-quit-rate-heavy-smokers-not-aiming-quit Daily Vaping Dramatically Ups Quit Rate in Heavy Smokers Not Aiming to Quit]
*Press Release: [https://www.roswellpark.org/newsroom/202112-daily-vaping-dramatically-ups-quit-rate-heavy-smokers-not-aiming-quit Daily Vaping Dramatically Ups Quit Rate in Heavy Smokers Not Aiming to Quit]
===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.
*“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
*[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4245610/pdf/ijerph-11-11220.pdf PDF Version]
===2014: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4247211/ Success rates with nicotine personal vaporizers: a prospective 6-month pilot study of smokers not intending to quit]===
*Complete tobacco cessation is the best outcome for smokers, but the powerful addictive qualities of nicotine and of the ritualistic behavior of smoking create a huge hurdle, even for those with a strong desire to quit. Tobacco harm reduction (THR), the substitution of low-risk nicotine products for cigarette smoking, is a realistic strategy for smokers who have difficulty quitting. E-cigarettes are the newest and most promising products for THR. This approach has been recently exploited to reduce or reverse the burden of harm in smokers with mental health disorders and chronic airway disease.
*[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4247211/pdf/12889_2014_Article_7263.pdf PDF Version]


=== 2013: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3691171/ EffiCiency and Safety of an eLectronic cigAreTte (ECLAT) as Tobacco Cigarettes Substitute: A Prospective 12-Month Randomized Control Design Study] ===
=== 2013: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3691171/ EffiCiency and Safety of an eLectronic cigAreTte (ECLAT) as Tobacco Cigarettes Substitute: A Prospective 12-Month Randomized Control Design Study] ===
* ECLAT is a prospective 12-month randomized, controlled trial that evaluates smoking reduction/abstinence in 300 smokers not intending to quit experimenting two different nicotine strengths of a popular e-cigarette model compared to its non-nicotine choice.
* ECLAT is a prospective 12-month randomized, controlled trial that evaluates smoking reduction/abstinence in 300 smokers not intending to quit experimenting two different nicotine strengths of a popular e-cigarette model compared to its non-nicotine choice.
* The study consisted of nine visits during which cig/day use and exhaled carbon monoxide (eCO) levels were measured. Smoking reduction and abstinence rates were calculated. Adverse events and product preferences were also reviewed.
* The study consisted of nine visits during which cig/day use and exhaled carbon monoxide (eCO) levels were measured. Smoking reduction and abstinence rates were calculated. Adverse events and product preferences were also reviewed.
* In smokers not intending to quit, the use of e-cigarettes<kbd>,</kbd> with or without nicotine, decreased cigarette consumption and elicited enduring tobacco abstinence without causing significant side effects.
* In smokers not intending to quit, the use of e-cigarettes<kbd>,</kbd> with or without nicotine, decreased cigarette consumption and elicited enduring tobacco abstinence without causing significant side effects.
* Caponnetto P, Campagna D, Cibella F, Morjaria JB, Caruso M, Russo C, Polosa R. PLoS One. 2013 Jun 24;8(6):e66317. doi: 10.1371/journal.pone.0066317
* Caponnetto P, Campagna D, Cibella F, Morjaria JB, Caruso M, Russo C, Polosa R. PLoS One. 2013 Jun 24;8(6):e66317. doi: 10.1371/journal.pone.0066317
===2011: [https://pubmed.ncbi.nlm.nih.gov/21989407/ Effect of an electronic nicotine delivery device (e-Cigarette) on smoking reduction and cessation: a prospective 6-month pilot study]===
*Sustained 50% reduction in the number of cig/day at week-24 was shown in 13/40(32.5%) participants; their median of 25 cigs/day decreasing to 6 cigs/day (p < 0.001). Sustained 80% reduction was shown in 5/40(12.5%) participants; their median of 30 cigs/day decreasing to 3 cigs/day (p = 0.043). Sustained smoking abstinence at week-24 was observed in 9/40(22.5%) participants, with 6/9 still using the e-Cigarette by the end of the study. Combined sustained 50% reduction and smoking abstinence was shown in 22/40 (55%) participants, with an overall 88% fall in cigs/day.
*The use of e-Cigarette substantially decreased cigarette consumption without causing significant side effects in smokers not intending to quit
*[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3203079/pdf/1471-2458-11-786.pdf PDF Version]
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='''Combined Intending and Not Intending to Quit Smoking'''=
='''Combined Intending and Not Intending to Quit Smoking'''=
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*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.
*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.
*[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4375383/pdf/ntu200.pdf PDF Version]
*[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4375383/pdf/ntu200.pdf PDF Version]
===2015: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4464650/ Electronic Cigarettes Efficacy and Safety at 12 Months: Cohort Study]===
*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]
===2013: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3850892/ A fresh look at tobacco harm reduction: the case for the electronic cigarette]===
*Smokers of any age can reap substantial health benefits by quitting. In fact, no other single public health effort is likely to achieve a benefit comparable to large-scale smoking cessation.
*E-cigs might be the most promising product for tobacco harm reduction to date, because, besides delivering nicotine vapour without the combustion products that are responsible for nearly all of smoking’s damaging effect, they also replace some of the rituals associated with smoking behaviour.
*Nicotine’s beneficial effects include correcting problems with concentration, attention and memory, as well as improving symptoms of mood impairments. Keeping such disabilities at bay right now can be much stronger motivation to continue using nicotine than any threats of diseases that may strike
*Nicotine’s beneficial effects can be controlled, and the detrimental effects of the smoky delivery system can be attenuated, by providing the drug via less hazardous delivery systems. Although more research is needed, e-cigs appear to be effective cigarette substitutes for inveterate smokers, and the health improvements enjoyed by switchers do not differ from those enjoyed by tobacco/nicotine abstainers.
*[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3850892/pdf/1477-7517-10-19.pdf PDF Version]
===2013: [https://academic.oup.com/ntr/article/15/10/1737/1183788 E-Cigarettes: Prevalence and Attitudes in Great Britain]===
*While we found evidence supporting the view that e-cigarette use may be a bridge to quitting, we found very little evidence of e-cigarette use among adults who had never smoked. British smokers would benefit from information about the effective use, risks, and benefits of e-cigarettes, as this might enable the use of e-cigarettes to improve public health.
*[https://scholar.google.com/scholar_url?url=https://academic.oup.com/ntr/article-pdf/15/10/1737/4005852/ntt057.pdf&hl=en&sa=T&oi=ucasa&ct=ufr&ei=5-niYKGiHo6RywT0wZbgCg&scisig=AAGBfm1x30ekBGwfhPgkxdJKFW0eOfPFPw PDF Version]
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*Long-term use of e-cigarettes was associated with a higher rate of quitting smoking.
*Long-term use of e-cigarettes was associated with a higher rate of quitting smoking.
*[https://tobaccocontrol.bmj.com/content/tobaccocontrol/25/Suppl_1/i90.full.pdf PDF Version]
*[https://tobaccocontrol.bmj.com/content/tobaccocontrol/25/Suppl_1/i90.full.pdf PDF Version]
===2014: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4511704/ Reasons for quitting cigarette smoking and electronic cigarette use for cessation help]===
*Thus, this may be the first study to suggest that smokers who want to quit smoking for immediate, extrinsic rewards may be attracted to use e-cigarettes to stop smoking cigarettes than smokers who want to quit smoking for intrinsic reasons such as health concerns. In conclusion, e-cigarettes appear to provide a “smoking” alternative to a section of cigarette smokers who may not quit smoking for health reasons. Public health efforts may need to consider employing e-cigarettes to promote tobacco-related harm reduction.
*[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4511704/pdf/nihms676311.pdf PDF Version]
===2014: [https://academic.oup.com/ntr/article-abstract/17/2/245/1258995 Cigarette Users’ Interest in Using or Switching to Electronic Nicotine Delivery Systems (ENDS) for Smokeless Tobacco for Harm Reduction, Cessation, or Novelty: A Cross-Sectional Survey of US Adults]===
*This study highlights higher interest in ENDS versus smokeless tobacco and greater interest in both for harm reduction and cessation than due to novelty or smoking restrictions. Developing educational campaigns and informing practitioners about caveats around ENDS as cessation or harm reduction aids are critical.
*[https://sci-hub.st/10.1093/ntr/ntu103 PDF Version]
===2013: [https://pubmed.ncbi.nlm.nih.gov/23551515/ 'Vaping' profiles and preferences: an online survey of electronic cigarette users]===
*Seventy-four percent of participants reported not smoking for at least a few weeks since using the e-cigarette and 70% reported reduced urge to smoke. *Seventy-two percent of participants used a 'tank' system, most commonly. Mean duration of use was 10 months. Only 1% reported exclusive use of non-nicotine containing liquid. E-cigarettes were generally considered to be satisfying to use; elicit few side effects; be healthier than smoking; improve cough/breathing; and be associated with low levels of craving. Among ex-smokers, 'time to first vape' was significantly longer than 'time to first cigarette' suggesting a lower level of dependence to e-cigarettes. Ex-smokers reported significantly greater reduction in craving than current smokers.
*E-cigarettes are used primarily for smoking cessation, but for a longer duration than nicotine replacement therapy, and users believe them to be safer than smoking
*[https://sci-hub.st/10.1111/add.12150 PDF Version]
===2012: [https://www.sciencedirect.com/science/article/abs/pii/S0306460312000913 The electronic-cigarette: Effects on desire to smoke, withdrawal symptoms and cognition]===
*The e-cigarette can reduce desire to smoke and nicotine withdrawal symptoms 20 minutes after use.
*The nicotine content in this respect may be more important for males.
*The first study to demonstrate that the nicotine e-cigarette can improve working memory.
*[https://sci-hub.se/10.1016/j.addbeh.2012.03.004 PDF Version]
===2011: [https://jmedicalcasereports.biomedcentral.com/articles/10.1186/1752-1947-5-585 Successful smoking cessation with electronic cigarettes in smokers with a documented history of recurring relapses: a case series]===
*The most important message from this case series is that these smokers, with a documented history of recurring relapses, were able to quit smoking and to remain abstinent for at least six months after taking up an electronic cigarette.
*[https://jmedicalcasereports.biomedcentral.com/track/pdf/10.1186/1752-1947-5-585.pdf PDF Version]
===2011: [https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1360-0443.2011.03505.x Electronic cigarette: users profile, utilization, satisfaction and perceived efficacy]===
*Almost all (97%) used e‐cigarettes containing nicotine.
*Most (96%) said the e‐cigarette helped them to quit smoking or reduce their smoking (92%).
*Reasons for using the e‐cigarette included the perception that it was less toxic than tobacco (84%), to deal with craving for tobacco (79%) and withdrawal symptoms (67%), to quit smoking or avoid relapsing (77%), because it was cheaper than smoking (57%) and to deal with situations where smoking was prohibited (39%).
*Most ex‐smokers (79%) feared they might relapse to smoking if they stopped using the e‐cigarette.
*Users of nicotine‐containing e‐cigarettes reported better relief of withdrawal and a greater effect on smoking cessation than those using non‐nicotine e‐cigarettes.
*[https://sci-hub.se/10.1111/j.1360-0443.2011.03505.x PDF Version]
===2011: [https://www.sciencedirect.com/science/article/abs/pii/S0749379710007920 Electronic Cigarettes As a Smoking-Cessation Tool: Results from an Online Survey]===
*A large percentage of respondents reported a reduction in the number of cigarettes they smoked (66.8%) and almost half reported abstinence from smoking for a period of time (48.8%). Those respondents using e-cigarettes more than 20 times per day had a quit rate of 70.0%. Of respondents who were not smoking at 6 months, 34.3% were not using e-cigarettes or any nicotine-containing products at the time.
*The distinct and unique advantage of e-cigarettes is that they allow individuals to utilize one device that can simultaneously address nicotine withdrawal, psychological factors, and behavioral cues that serve as barriers to smoking abstinence.
*[https://sci-hub.se/10.1016/j.amepre.2010.12.006 PDF Version]
===2011: [https://academic.oup.com/ntr/article/13/9/860/1134354 Interviews With “Vapers”: Implications for Future Research With Electronic Cigarettes]===
*Experienced users report health gains typical for smoking cessation despite continued vaping.
*There were pervasive themes including the language and culture of vaping; social and informational support among vapers, motives and perceived benefits of using e-cigs versus cigarettes including cigarette-like enjoyment, cost, restored sense of taste and smell, and improved breathing and exercise tolerance; rapidly reduced nicotine tolerance and dependence; and a strong interest in e-cig–related research and policy.
*[https://sci-hub.se/10.1093/ntr/ntr088 PDF Version]
===2010: [https://tobaccocontrol.bmj.com/content/19/2/98 Effect of an electronic nicotine delivery device (e cigarette) on desire to smoke and withdrawal, user preferences and nicotine delivery: randomised cross-over trial]===
*Conclusions “The 16 mg Ruyan V8 ENDD alleviated desire to smoke after overnight abstinence, was well tolerated and had a pharmacokinetic profile more like the Nicorette inhalator than a tobacco cigarette. Evaluation of the ENDD for longer-term safety, potential for long-term use and efficacy as a cessation aid is needed.”
*[https://sci-hub.se/10.1136/tc.2009.031567 PDF Version]
===2010: [https://link.springer.com/article/10.1186/1471-2458-10-231 Electronic cigarettes: a survey of users]===
*Our results suggest that ecigarettes are used mainly to quit smoking, and may be useful for this purpose.
*[https://link.springer.com/content/pdf/10.1186%2F1471-2458-10-231.pdf PDF Version]
===2006: [https://tobaccocontrol.bmj.com/content/15/3/210 Role of snus in initiation and cessation of tobacco smoking in Sweden]===
*Use of snus in Sweden is associated with a reduced risk of becoming a daily smoker, and increased likelihood of stopping smoking
===2005: [https://tobaccocontrol.bmj.com/content/14/6/422 Is Swedish snus associated with smoking initiation or smoking cessation?]===
*“Among males participating in a large population based twin study in Sweden, snus use was associated with smoking cessation but not initiation.”
*[https://tobaccocontrol.bmj.com/content/tobaccocontrol/14/6/422.full.pdf PDF Version]
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*“In conclusion, during this brief trial, the e-cigarette was found to be more acceptable, provided more satisfaction and rewards, and had higher perceived benefit than the nicotine inhaler. These findings may explain why the e-cigarette has become popular among smokers while the inhaler has not achieved the same favorability. Based on this difference, e-cigarettes could have the potential to become “tobacco cigarette substitutes,” owing to their high acceptance and perceived effectiveness. While toxicants have been identified in e-cigarettes, they are present at orders of magnitude lower than tobacco cigarettes. As such, e-cigarettes may hold value as a harm reduction strategy among those unwilling or unable to quit. However, given the large variation in the market with respect to brands, more data are needed to demonstrate their efficacy and safety, and to allow physicians to more appropriately inform their patients about these products.”  
*“In conclusion, during this brief trial, the e-cigarette was found to be more acceptable, provided more satisfaction and rewards, and had higher perceived benefit than the nicotine inhaler. These findings may explain why the e-cigarette has become popular among smokers while the inhaler has not achieved the same favorability. Based on this difference, e-cigarettes could have the potential to become “tobacco cigarette substitutes,” owing to their high acceptance and perceived effectiveness. While toxicants have been identified in e-cigarettes, they are present at orders of magnitude lower than tobacco cigarettes. As such, e-cigarettes may hold value as a harm reduction strategy among those unwilling or unable to quit. However, given the large variation in the market with respect to brands, more data are needed to demonstrate their efficacy and safety, and to allow physicians to more appropriately inform their patients about these products.”  
*[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4238186/pdf/11606_2014_Article_2889.pdf PDF Version]
*[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4238186/pdf/11606_2014_Article_2889.pdf PDF Version]
===2014: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4171752/ Real-world effectiveness of e-cigarettes when used to aid smoking cessation: a cross-sectional population study]===
*Conclusion: “Among smokers who have attempted to stop without professional support, those who use e-cigarettes are more likely to report continued abstinence than those who used a licensed NRT product bought over-the-counter or no aid to cessation. This difference persists after adjusting for a range of smoker characteristics such as nicotine dependence.”
*[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4171752/pdf/add0109-1531.pdf PDF Version]
===2013: [https://pubmed.ncbi.nlm.nih.gov/24029165/ Electronic cigarettes for smoking cessation: a randomised controlled trial]===
*657 people were randomised (289 to nicotine e-cigarettes, 295 to patches, and 73 to placebo e-cigarettes) and were included in the intention-to-treat analysis.
*At 6 months, verified abstinence was 7·3% (21 of 289) with nicotine e-cigarettes, 5·8% (17 of 295) with patches, and 4·1% (three of 73) with placebo e-cigarettes
*[https://sci-hub.st/10.1016/S0140-6736(13)61842-5 PDF Version]
===2013: [https://www.frontiersin.org/articles/10.3389/fpubh.2013.00056/full Electronic cigarettes and vaping: a new challenge in clinical medicine and public health. A literature review]===
*When compared to the harmful effects of smoking, these studies suggest that vaping could be used as a possible “harm reduction” tool. There is evidence supporting e-cigarettes as an aide for smoking cessation, at least as successful as currently available FDA-approved NRTs.
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*This study describes the advice that former-smokers who used e-cigarettes to quit smoking would offer to smokers who are considering using an e-cigarette to support an attempt to quit smoking. Vapers advised smokers to find the right combination of device, flavors and nicotine strength, continue to smoke and vape for a while if they wished, not be deterred by past failed attempts to quit smoking, and expect health to improve after they have switched to vaping. Encouraging smokers to interact with vaping peers in vape shops and in online vaping-dedicated discussion forums may help significantly more smokers switch to vaping.
*This study describes the advice that former-smokers who used e-cigarettes to quit smoking would offer to smokers who are considering using an e-cigarette to support an attempt to quit smoking. Vapers advised smokers to find the right combination of device, flavors and nicotine strength, continue to smoke and vape for a while if they wished, not be deterred by past failed attempts to quit smoking, and expect health to improve after they have switched to vaping. Encouraging smokers to interact with vaping peers in vape shops and in online vaping-dedicated discussion forums may help significantly more smokers switch to vaping.
*[https://sci-hub.do/10.1093/ntr/ntx176# PDF Version]
*[https://sci-hub.do/10.1093/ntr/ntx176# PDF Version]
===2014: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4025024/ Characteristics, Perceived Side Effects and Benefits of Electronic Cigarette Use: A Worldwide Survey of More than 19,000 Consumers]===
*The main results of this survey indicate that ECs may be an effective substitute for smoking even in highly dependent subjects who are heavy smokers. Significant benefits are experienced by these people in physiologic functions and in some disease conditions, with former smokers (those who completely substituted smoking with EC use) being more likely to report such beneficial effects.
*Both former and current smokers initiated EC use with high nicotine-containing liquids. More than one-fifth of the population initiated use with more than 20 mg/mL nicotine concentration, with higher prevalence in former smokers, supporting the hypothesis that nicotine plays an important role in the success of ECs as smoking substitutes. This can be attributed to the lower nicotine absorption from EC use compared to smoking. Such repeated observations should be taken into consideration by the regulatory authorities.
*The most important reasons for participants to initiate ECs were to reduce or completely quit smoking and to reduce exposure of family members to second-hand smoking. It seems that these subjects are well-informed about the adverse health effects of smoking and are willing to try an alternative product which they consider less harmful.
*In conclusion, in this large sample of dedicated EC users, it seems that ECs are used as long-term substitutes to smoking. They can be effective even in subjects who are highly dependent on smoking and are heavy smokers. Mild temporary side-effects and significant benefits are reported by this population. Motivation for using ECs comes from their expected less harmful potential compared to smoking.
*[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4025024/pdf/ijerph-11-04356.pdf PDF Version]


===2013: [https://journals.sagepub.com/doi/full/10.4137/SART.S12756 Evaluating Nicotine Levels Selection and Patterns of Electronic Cigarette use in a Group of  “Vapers” Who Had Achieved Complete Substitution of Smoking]===
===2013: [https://journals.sagepub.com/doi/full/10.4137/SART.S12756 Evaluating Nicotine Levels Selection and Patterns of Electronic Cigarette use in a Group of  “Vapers” Who Had Achieved Complete Substitution of Smoking]===
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===See Also: [https://safernicotine.wiki/mediawiki/index.php/ENDS_Flavors ENDS - Flavors] and [https://safernicotine.wiki/mediawiki/index.php/Nicotine_-_Banning_Flavors_-_Opposition Nicotine - Banning Flavors - Opposition]===
===See Also: [https://safernicotine.wiki/mediawiki/index.php/ENDS_Flavors ENDS - Flavors] and [https://safernicotine.wiki/mediawiki/index.php/Nicotine_-_Banning_Flavors_-_Opposition Nicotine - Banning Flavors - Opposition]===
===2023: [https://pubmed.ncbi.nlm.nih.gov/38127516/ Randomized trial assessing the effect of the JUUL system on switching away from cigarettes and smoking reduction among U.S. adults who smoke cigarettes]===
*Use of JUUL products may support complete switching away from cigarettes, including among those not ready to quit smoking. Results suggest a preference for nontobacco-flavored ENDS among adults who smoke, although smoking outcomes did not differ by flavor.


===2022: [https://pubmed.ncbi.nlm.nih.gov/36250607/ Associations between e-cigarette use and e-cigarette flavors with cigarette smoking quit attempts and quit success: Evidence from a US large, nationally representative 2018-2019 survey]===
===2022: [https://pubmed.ncbi.nlm.nih.gov/36250607/ Associations between e-cigarette use and e-cigarette flavors with cigarette smoking quit attempts and quit success: Evidence from a US large, nationally representative 2018-2019 survey]===
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*Results: At follow-up, 23% were intensive users... 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.  
*Results: At follow-up, 23% were intensive users... 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.  
*[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4375383/pdf/ntu200.pdf PDF Version]
*[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4375383/pdf/ntu200.pdf PDF Version]
===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]===
*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]
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*[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6751515/pdf/nty141.pdf PDF Version]
*[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6751515/pdf/nty141.pdf PDF Version]


= Long Term usage =
= '''Long Term usage''' =


=== 2023: [https://pubmed.ncbi.nlm.nih.gov/37866230/ An 8-year longitudinal study of long-term, continuous users of electronic cigarettes.] (2012-2016 to 2021 8 years is the average) ===
=== 2023: [https://pubmed.ncbi.nlm.nih.gov/37866230/ An 8-year longitudinal study of long-term, continuous users of electronic cigarettes.] (2012-2016 to 2021 8 years is the average) ===
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=Drug or Alcohol Treatment Facilities=
=Drug or Alcohol Treatment Facilities=
=Studies - Not Catagorized=
===2015: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4464650/ Electronic Cigarettes Efficacy and Safety at 12 Months: Cohort Study]===
*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]
===2014: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4171752/ Real-world effectiveness of e-cigarettes when used to aid smoking cessation: a cross-sectional population study]===
*Conclusion: “Among smokers who have attempted to stop without professional support, those who use e-cigarettes are more likely to report continued abstinence than those who used a licensed NRT product bought over-the-counter or no aid to cessation. This difference persists after adjusting for a range of smoker characteristics such as nicotine dependence.”
*[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4171752/pdf/add0109-1531.pdf PDF Version]
===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.
*“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
*[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4245610/pdf/ijerph-11-11220.pdf PDF Version]
===2014: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4247211/ Success rates with nicotine personal vaporizers: a prospective 6-month pilot study of smokers not intending to quit]===
*Complete tobacco cessation is the best outcome for smokers, but the powerful addictive qualities of nicotine and of the ritualistic behavior of smoking create a huge hurdle, even for those with a strong desire to quit. Tobacco harm reduction (THR), the substitution of low-risk nicotine products for cigarette smoking, is a realistic strategy for smokers who have difficulty quitting. E-cigarettes are the newest and most promising products for THR. This approach has been recently exploited to reduce or reverse the burden of harm in smokers with mental health disorders and chronic airway disease.
*[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4247211/pdf/12889_2014_Article_7263.pdf PDF Version]
===2014: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4025024/ Characteristics, Perceived Side Effects and Benefits of Electronic Cigarette Use: A Worldwide Survey of More than 19,000 Consumers]===
*The main results of this survey indicate that ECs may be an effective substitute for smoking even in highly dependent subjects who are heavy smokers. Significant benefits are experienced by these people in physiologic functions and in some disease conditions, with former smokers (those who completely substituted smoking with EC use) being more likely to report such beneficial effects.
*Both former and current smokers initiated EC use with high nicotine-containing liquids. More than one-fifth of the population initiated use with more than 20 mg/mL nicotine concentration, with higher prevalence in former smokers, supporting the hypothesis that nicotine plays an important role in the success of ECs as smoking substitutes. This can be attributed to the lower nicotine absorption from EC use compared to smoking. Such repeated observations should be taken into consideration by the regulatory authorities.
*The most important reasons for participants to initiate ECs were to reduce or completely quit smoking and to reduce exposure of family members to second-hand smoking. It seems that these subjects are well-informed about the adverse health effects of smoking and are willing to try an alternative product which they consider less harmful.
*In conclusion, in this large sample of dedicated EC users, it seems that ECs are used as long-term substitutes to smoking. They can be effective even in subjects who are highly dependent on smoking and are heavy smokers. Mild temporary side-effects and significant benefits are reported by this population. Motivation for using ECs comes from their expected less harmful potential compared to smoking.
*[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4025024/pdf/ijerph-11-04356.pdf PDF Version]
===2014: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4511704/ Reasons for quitting cigarette smoking and electronic cigarette use for cessation help]===
*Thus, this may be the first study to suggest that smokers who want to quit smoking for immediate, extrinsic rewards may be attracted to use e-cigarettes to stop smoking cigarettes than smokers who want to quit smoking for intrinsic reasons such as health concerns. In conclusion, e-cigarettes appear to provide a “smoking” alternative to a section of cigarette smokers who may not quit smoking for health reasons. Public health efforts may need to consider employing e-cigarettes to promote tobacco-related harm reduction.
*[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4511704/pdf/nihms676311.pdf PDF Version]
===2014: [https://academic.oup.com/ntr/article-abstract/17/2/245/1258995 Cigarette Users’ Interest in Using or Switching to Electronic Nicotine Delivery Systems (ENDS) for Smokeless Tobacco for Harm Reduction, Cessation, or Novelty: A Cross-Sectional Survey of US Adults]===
*This study highlights higher interest in ENDS versus smokeless tobacco and greater interest in both for harm reduction and cessation than due to novelty or smoking restrictions. Developing educational campaigns and informing practitioners about caveats around ENDS as cessation or harm reduction aids are critical.
*[https://sci-hub.st/10.1093/ntr/ntu103 PDF Version]
===2013: [https://pubmed.ncbi.nlm.nih.gov/24029165/ Electronic cigarettes for smoking cessation: a randomised controlled trial]===
*657 people were randomised (289 to nicotine e-cigarettes, 295 to patches, and 73 to placebo e-cigarettes) and were included in the intention-to-treat analysis.
*At 6 months, verified abstinence was 7·3% (21 of 289) with nicotine e-cigarettes, 5·8% (17 of 295) with patches, and 4·1% (three of 73) with placebo e-cigarettes
*[https://sci-hub.st/10.1016/S0140-6736(13)61842-5 PDF Version]
===2013: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3850892/ A fresh look at tobacco harm reduction: the case for the electronic cigarette]===
*Smokers of any age can reap substantial health benefits by quitting. In fact, no other single public health effort is likely to achieve a benefit comparable to large-scale smoking cessation.
*E-cigs might be the most promising product for tobacco harm reduction to date, because, besides delivering nicotine vapour without the combustion products that are responsible for nearly all of smoking’s damaging effect, they also replace some of the rituals associated with smoking behaviour.
*Nicotine’s beneficial effects include correcting problems with concentration, attention and memory, as well as improving symptoms of mood impairments. Keeping such disabilities at bay right now can be much stronger motivation to continue using nicotine than any threats of diseases that may strike
*Nicotine’s beneficial effects can be controlled, and the detrimental effects of the smoky delivery system can be attenuated, by providing the drug via less hazardous delivery systems. Although more research is needed, e-cigs appear to be effective cigarette substitutes for inveterate smokers, and the health improvements enjoyed by switchers do not differ from those enjoyed by tobacco/nicotine abstainers.
*[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3850892/pdf/1477-7517-10-19.pdf PDF Version]
===2013: [https://www.frontiersin.org/articles/10.3389/fpubh.2013.00056/full Electronic cigarettes and vaping: a new challenge in clinical medicine and public health. A literature review]===
*When compared to the harmful effects of smoking, these studies suggest that vaping could be used as a possible “harm reduction” tool. There is evidence supporting e-cigarettes as an aide for smoking cessation, at least as successful as currently available FDA-approved NRTs.
===2013: [https://academic.oup.com/ntr/article/15/10/1737/1183788 E-Cigarettes: Prevalence and Attitudes in Great Britain]===
*While we found evidence supporting the view that e-cigarette use may be a bridge to quitting, we found very little evidence of e-cigarette use among adults who had never smoked. British smokers would benefit from information about the effective use, risks, and benefits of e-cigarettes, as this might enable the use of e-cigarettes to improve public health.
*[https://scholar.google.com/scholar_url?url=https://academic.oup.com/ntr/article-pdf/15/10/1737/4005852/ntt057.pdf&hl=en&sa=T&oi=ucasa&ct=ufr&ei=5-niYKGiHo6RywT0wZbgCg&scisig=AAGBfm1x30ekBGwfhPgkxdJKFW0eOfPFPw PDF Version]
===2013: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3691171/ EffiCiency and Safety of an eLectronic cigAreTte (ECLAT) as Tobacco Cigarettes Substitute: A Prospective 12-Month Randomized Control Design Study]===
*In smokers not intending to quit, the use of e-cigarettes, with or without nicotine, decreased cigarette consumption and elicited enduring tobacco abstinence without causing significant side effects. In view of the fact that subjects in this study had no immediate intention of quitting, the reported overall abstinence rate of 8.7% at 52-week was remarkable.
*[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3691171/pdf/pone.0066317.pdf PDF Version]
===2013: [https://pubmed.ncbi.nlm.nih.gov/23551515/ 'Vaping' profiles and preferences: an online survey of electronic cigarette users]===
*Seventy-four percent of participants reported not smoking for at least a few weeks since using the e-cigarette and 70% reported reduced urge to smoke. *Seventy-two percent of participants used a 'tank' system, most commonly. Mean duration of use was 10 months. Only 1% reported exclusive use of non-nicotine containing liquid. E-cigarettes were generally considered to be satisfying to use; elicit few side effects; be healthier than smoking; improve cough/breathing; and be associated with low levels of craving. Among ex-smokers, 'time to first vape' was significantly longer than 'time to first cigarette' suggesting a lower level of dependence to e-cigarettes. Ex-smokers reported significantly greater reduction in craving than current smokers.
*E-cigarettes are used primarily for smoking cessation, but for a longer duration than nicotine replacement therapy, and users believe them to be safer than smoking
*[https://sci-hub.st/10.1111/add.12150 PDF Version]
===2012: [https://www.sciencedirect.com/science/article/abs/pii/S0306460312000913 The electronic-cigarette: Effects on desire to smoke, withdrawal symptoms and cognition]===
*The e-cigarette can reduce desire to smoke and nicotine withdrawal symptoms 20 minutes after use.
*The nicotine content in this respect may be more important for males.
*The first study to demonstrate that the nicotine e-cigarette can improve working memory.
*[https://sci-hub.se/10.1016/j.addbeh.2012.03.004 PDF Version]
===2011: [https://jmedicalcasereports.biomedcentral.com/articles/10.1186/1752-1947-5-585 Successful smoking cessation with electronic cigarettes in smokers with a documented history of recurring relapses: a case series]===
*The most important message from this case series is that these smokers, with a documented history of recurring relapses, were able to quit smoking and to remain abstinent for at least six months after taking up an electronic cigarette.
*[https://jmedicalcasereports.biomedcentral.com/track/pdf/10.1186/1752-1947-5-585.pdf PDF Version]
===2011: [https://pubmed.ncbi.nlm.nih.gov/21989407/ Effect of an electronic nicotine delivery device (e-Cigarette) on smoking reduction and cessation: a prospective 6-month pilot study]===
*Sustained 50% reduction in the number of cig/day at week-24 was shown in 13/40(32.5%) participants; their median of 25 cigs/day decreasing to 6 cigs/day (p < 0.001). Sustained 80% reduction was shown in 5/40(12.5%) participants; their median of 30 cigs/day decreasing to 3 cigs/day (p = 0.043). Sustained smoking abstinence at week-24 was observed in 9/40(22.5%) participants, with 6/9 still using the e-Cigarette by the end of the study. Combined sustained 50% reduction and smoking abstinence was shown in 22/40 (55%) participants, with an overall 88% fall in cigs/day.
*The use of e-Cigarette substantially decreased cigarette consumption without causing significant side effects in smokers not intending to quit
*[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3203079/pdf/1471-2458-11-786.pdf PDF Version]
===2011: [https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1360-0443.2011.03505.x Electronic cigarette: users profile, utilization, satisfaction and perceived efficacy]===
*Almost all (97%) used e‐cigarettes containing nicotine.
*Most (96%) said the e‐cigarette helped them to quit smoking or reduce their smoking (92%).
*Reasons for using the e‐cigarette included the perception that it was less toxic than tobacco (84%), to deal with craving for tobacco (79%) and withdrawal symptoms (67%), to quit smoking or avoid relapsing (77%), because it was cheaper than smoking (57%) and to deal with situations where smoking was prohibited (39%).
*Most ex‐smokers (79%) feared they might relapse to smoking if they stopped using the e‐cigarette.
*Users of nicotine‐containing e‐cigarettes reported better relief of withdrawal and a greater effect on smoking cessation than those using non‐nicotine e‐cigarettes.
*[https://sci-hub.se/10.1111/j.1360-0443.2011.03505.x PDF Version]
===2011: [https://www.sciencedirect.com/science/article/abs/pii/S0749379710007920 Electronic Cigarettes As a Smoking-Cessation Tool: Results from an Online Survey]===
*A large percentage of respondents reported a reduction in the number of cigarettes they smoked (66.8%) and almost half reported abstinence from smoking for a period of time (48.8%). Those respondents using e-cigarettes more than 20 times per day had a quit rate of 70.0%. Of respondents who were not smoking at 6 months, 34.3% were not using e-cigarettes or any nicotine-containing products at the time.
*The distinct and unique advantage of e-cigarettes is that they allow individuals to utilize one device that can simultaneously address nicotine withdrawal, psychological factors, and behavioral cues that serve as barriers to smoking abstinence.
*[https://sci-hub.se/10.1016/j.amepre.2010.12.006 PDF Version]
===2011: [https://academic.oup.com/ntr/article/13/9/860/1134354 Interviews With “Vapers”: Implications for Future Research With Electronic Cigarettes]===
*Experienced users report health gains typical for smoking cessation despite continued vaping.
*There were pervasive themes including the language and culture of vaping; social and informational support among vapers, motives and perceived benefits of using e-cigs versus cigarettes including cigarette-like enjoyment, cost, restored sense of taste and smell, and improved breathing and exercise tolerance; rapidly reduced nicotine tolerance and dependence; and a strong interest in e-cig–related research and policy.
*[https://sci-hub.se/10.1093/ntr/ntr088 PDF Version]
===2010: [https://tobaccocontrol.bmj.com/content/19/2/98 Effect of an electronic nicotine delivery device (e cigarette) on desire to smoke and withdrawal, user preferences and nicotine delivery: randomised cross-over trial]===
*Conclusions “The 16 mg Ruyan V8 ENDD alleviated desire to smoke after overnight abstinence, was well tolerated and had a pharmacokinetic profile more like the Nicorette inhalator than a tobacco cigarette. Evaluation of the ENDD for longer-term safety, potential for long-term use and efficacy as a cessation aid is needed.”
*[https://sci-hub.se/10.1136/tc.2009.031567 PDF Version]
===2010: [https://link.springer.com/article/10.1186/1471-2458-10-231 Electronic cigarettes: a survey of users]===
*Our results suggest that ecigarettes are used mainly to quit smoking, and may be useful for this purpose.
*[https://link.springer.com/content/pdf/10.1186%2F1471-2458-10-231.pdf PDF Version]
===2006: [https://tobaccocontrol.bmj.com/content/15/3/210 Role of snus in initiation and cessation of tobacco smoking in Sweden]===
*Use of snus in Sweden is associated with a reduced risk of becoming a daily smoker, and increased likelihood of stopping smoking
===2005: [https://tobaccocontrol.bmj.com/content/14/6/422 Is Swedish snus associated with smoking initiation or smoking cessation?]===
*“Among males participating in a large population based twin study in Sweden, snus use was associated with smoking cessation but not initiation.”
*[https://tobaccocontrol.bmj.com/content/tobaccocontrol/14/6/422.full.pdf PDF Version]


='''Shareables'''=
='''Shareables'''=
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='''Suggestions to Add to This Page'''=
='''Suggestions to Add to This Page'''=


===2023: [https://pubmed.ncbi.nlm.nih.gov/38127516/ Randomized trial assessing the effect of the JUUL system on switching away from cigarettes and smoking reduction among U.S. adults who smoke cigarettes]===
===2024: [https://pubmed.ncbi.nlm.nih.gov/38653554/ A qualitative study of using nicotine products for smoking cessation after discharge from residential drug and alcohol treatment in Australia]===
 
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