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E-Cigarettes and Smoking Cessation: Evidence from a Systematic Review and Meta-Analysis

Author

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  • Muhammad Aziz Rahman
  • Nicholas Hann
  • Andrew Wilson
  • George Mnatzaganian
  • Linda Worrall-Carter

Abstract

Background: E-cigarettes are currently being debated regarding their possible role in smoking cessation and as they are becoming increasingly popular, the research to date requires investigation. Objectives: To investigate whether the use of e-cigarettes is associated with smoking cessation or reduction, and whether there is any difference in efficacy of e-cigarettes with and without nicotine on smoking cessation. Data Sources: A systematic review of articles with no limit on publication date was conducted by searching PubMed, Web of Knowledge and Scopus databases. Methods: Published studies, those reported smoking abstinence or reduction in cigarette consumption after the use of e-cigarettes, were included. Studies were systematically reviewed, and meta-analyses were conducted using Mantel-Haenszel fixed-effect and random-effects models. Degree of heterogeneity among studies and quality of the selected studies were evaluated. Results: Six studies were included involving 7,551 participants. Meta-analyses included 1,242 participants who had complete data on smoking cessation. Nicotine filled e-cigarettes were more effective for cessation than those without nicotine (pooled Risk Ratio 2.29, 95%CI 1.05-4.97). Amongst 1,242 smokers, 224 (18%) reported smoking cessation after using nicotine-enriched e-cigarettes for a minimum period of six months. Use of such e-cigarettes was positively associated with smoking cessation with a pooled Effect Size of 0.20 (95%CI 0.11-0.28). Use of e-cigarettes was also associated with a reduction in the number of cigarettes used. Limitations: Included studies were heterogeneous, due to different study designs and gender variation. Whilst we were able to comment on the efficacy of nicotine vs. non-nicotine e-cigarettes for smoking cessation, we were unable to comment on the efficacy of e-cigarettes vs. other interventions for cessation, given the lack of comparator groups in the studies included in this meta-analysis. Conclusions: Use of e-cigarettes is associated with smoking cessation and reduction. More randomised controlled trials are needed to assess effectiveness against other cessation methods.

Suggested Citation

  • Muhammad Aziz Rahman & Nicholas Hann & Andrew Wilson & George Mnatzaganian & Linda Worrall-Carter, 2015. "E-Cigarettes and Smoking Cessation: Evidence from a Systematic Review and Meta-Analysis," PLOS ONE, Public Library of Science, vol. 10(3), pages 1-16, March.
    • Handle: RePEc:plo:pone00:0122544
    DOI: 10.1371/journal.pone.0122544
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    References listed on IDEAS

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    1. David Moher & Alessandro Liberati & Jennifer Tetzlaff & Douglas G Altman & The PRISMA Group, 2009. "Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement," PLOS Medicine, Public Library of Science, vol. 6(7), pages 1-6, July.
    2. Apelberg, B.J. & Onicescu, G. & Avila-Tang, E. & Samet, J.M., 2010. "Estimating the risks and benefits of nicotine replacement therapy for smoking cessation in the United States," American Journal of Public Health, American Public Health Association, vol. 100(2), pages 341-348.
    3. Pokhrel, P. & Fagan, P. & Little, M.A. & Kawamoto, C.T. & Herzog, T.A., 2013. "Smokers who try E-cigarettes to quit smoking: Findings from a multiethnic study in Hawaii," American Journal of Public Health, American Public Health Association, vol. 103(9), pages 57-62.
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    Cited by:

    1. Jidong Huang & Zongshuan Duan & Yu Wang & Pamela B. Redmon & Michael P. Eriksen, 2020. "Use of Electronic Nicotine Delivery Systems (ENDS) in China: Evidence from Citywide Representative Surveys from Five Chinese Cities in 2018," IJERPH, MDPI, vol. 17(7), pages 1-15, April.
    2. J. E. Prieger & A. Choi, 2024. "E-cigarettes and Smoking: Correlation, Causation, and Selection Bias," Journal of Consumer Policy, Springer, vol. 47(4), pages 471-498, December.
    3. Tomoyasu Hirano & Takahiro Tabuchi & Rika Nakahara & Naoki Kunugita & Yumiko Mochizuki-Kobayashi, 2017. "Electronic Cigarette Use and Smoking Abstinence in Japan: A Cross-Sectional Study of Quitting Methods," IJERPH, MDPI, vol. 14(2), pages 1-9, February.
    4. Socrates Yong-da Wu & Man Ping Wang & William H. Li & Antonio C. Kwong & Vienna W. Lai & Tai Hing Lam, 2018. "Does Electronic Cigarette Use Predict Abstinence from Conventional Cigarettes among Smokers in Hong Kong?," IJERPH, MDPI, vol. 15(3), pages 1-10, February.
    5. Kim AGJ Romijnders & Erna JZ Krüsemann & Sanne Boesveldt & Kees de Graaf & Hein de Vries & Reinskje Talhout, 2019. "E-Liquid Flavor Preferences and Individual Factors Related to Vaping: A Survey among Dutch Never-Users, Smokers, Dual Users, and Exclusive Vapers," IJERPH, MDPI, vol. 16(23), pages 1-15, November.
    6. Su Hyun Park & Lily Lee & Jenni A Shearston & Michael Weitzman, 2017. "Patterns of electronic cigarette use and level of psychological distress," PLOS ONE, Public Library of Science, vol. 12(3), pages 1-13, March.
    7. Adele Caldarelli & Rosanna Span? & Luca Ferri & Raffaela Casciello, 2020. "L?accounting change nel settore pubblico: primi spunti per una riflessione integrata," MANAGEMENT CONTROL, FrancoAngeli Editore, vol. 2020(1), pages 11-34.
    8. Ahmed M. Al Rajeh & Ilias Mahmud & Mahmudul Hassan Al Imam & Muhammad Aziz Rahman & Fariss Al Shehri & Salman Alomayrin & Nawaf Alfazae & Yousif Mohammed Elmosaad & Ibrahim Alasqah, 2022. "E-Cigarette Use among Male Smokers in Al-Ahsa, Kingdom of Saudi Arabia: A Cross-Sectional Study," IJERPH, MDPI, vol. 20(1), pages 1-13, December.

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