Success rates with nicotine personal vaporizers: a prospective 6-month pilot study of smokers not intending to quit

BMC Public Health

Cristina Russo²  Jaymin B Morjaria¹  Marilena Maglia²  Pasquale Caponnetto²  Riccardo Polosa³ 

[1]Department of Academic Respiratory Medicine, Hull York Medical School, University of Hull, Castle Hill Hospital, Castle Road, Cottingham Kingston HU16 5JQ, UK

[2]Dipartimento di Biomedicina Clinica e Molecolare, Università di Catania, Azienda Ospedaliero-Universitaria “Policlinico-Vittorio Emanuele”, Università di Catania, Catania, Italy

[3]UOC di Medicina Interna e d’Urgenza, Edificio 4, Piano 3, AOU “Policlinico-V. Emanuele”, Via S. Sofia 78, 95123 Catania, Italy

关键词: Tobacco harm reduction;    Safety;    Efficacy;    Personal vaporizers;    Electronic cigarette;    Smoking reduction;    Smoking cessation;   

Others  :  1122994
DOI  :  10.1186/1471-2458-14-1159

 received in 2014-05-04, accepted in 2014-10-10,  发布年份 2014

【 摘 要 】

Background

Electronic cigarettes (e-Cigs) are an attractive long-term alternative nicotine source to conventional cigarettes. Although they may assist smokers to remain abstinent during their quit attempt, studies using first generation e-Cigs report low success rates. Second generation devices (personal vaporisers - PVs) may result in much higher quit rates, but their efficacy and safety in smoking cessation and/or reduction in clinical trials is unreported.

Method

We conducted a prospective proof-of-concept study monitoring modifications in smoking behaviour of 50 smokers (unwilling to quit) switched onto PVs. Participants attended five study visits: baseline, week-4, week-8, week-12 and week-24. Number of cigarettes/day (cigs/day) and exhaled carbon monoxide (eCO) levels were noted at each visit. Smoking reduction/abstinence rates, product usage, adverse events and subjective opinions of these products were also reviewed.

Results

Sustained 50% and 80% reduction in cigs/day at week-24 was reported in 15/50 (30%) and 7/50 (14%) participants with a reduction from 25cigs/day to 6cigs/day (p < 0.001) and 3cigs/day (p < 0.001), respectively. Smoking abstinence (self-reported abstinence from cigarette smoking verified by an eCO ≤10 ppm) at week-24 was observed in 18/50 (36%) participants, with 15/18 (83.3%) still using their PVs at the end of the study. Combined 50% reduction and smoking abstinence was shown in 33/50 (66%) participants. Throat/mouth irritation (35.6%), dry throat/mouth (28.9%), headache (26.7%) and dry cough (22.2%) were frequently reported early in the study, but waned substantially by week-24. Participants’ perception and acceptance of the products was very good.

Conclusion

The use of second generation PVs substantially decreased cigarette consumption without causing significant adverse effects in smokers not intending to quit.

Trial registration

(ClinicalTrials.gov Identifier: NCT02124200)

【 授权许可】

   
2014 Polosa et al.; licensee BioMed Central Ltd.

【 图 表 】

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【 参考文献 】

• [1]Buchhalter AR, Acosta MC, Evans SE, Breland AB, Eissenberg T: Tobacco abstinence symptom suppression: the role played by the smoking-related stimuli that are delivered by denicotinized cigarettes. Addiction 2005, 100(4):550-559.
• [2]Hughes JR, Keely J, Naud S: Shape of the relapse curve and long-term abstinence among untreated smokers. Addiction 2004, 99(1):29-38.
• [3]Polosa R, Benowitz NL: Treatment of nicotine addiction: present therapeutic options and pipeline developments. Trends Pharmacol Sci 2011, 32(5):281-289.
• [4]Stead LF, Lancaster T: Combined pharmacotherapy and behavioural interventions for smoking cessation. Cochrane Database Syst Rev 2012, 10:CD008286.
• [5]Apelberg BJ, Onicescu G, Avila-Tang E, Samet JM: Estimating the risks and benefits of nicotine replacement therapy for smoking cessation in the United States. Am J Public Health 2010, 100(2):341-348.
• [6]Casella G, Caponnetto P, Polosa R: Therapeutic advances in the treatment of nicotine addiction: present and future. Ther Adv Chronic Dis 2010, 1(3):95-106.
• [7]Alpert HR, Connolly GN, Biener L: A prospective cohort study challenging the effectiveness of population-based medical intervention for smoking cessation. Tob Control 2013, 22(1):32-37.
• [8]Pierce JP, Cummins SE, White MM, Humphrey A, Messer K: Quitlines and nicotine replacement for smoking cessation: do we need to change policy? Annu Rev Public Health 2012, 33:341-356.
• [9]Zhu SH, Lee M, Zhuang YL, Gamst A, Wolfson T: Interventions to increase smoking cessation at the population level: how much progress has been made in the last two decades? Tob Control 2012, 21(2):110-118.
• [10]Caponnetto P, Campagna D, Papale G, Russo C, Polosa R: The emerging phenomenon of electronic cigarettes. Expert Rev Respir Med 2012, 6(1):63-74.
• [11]Caponnetto P, Russo C, Bruno CM, Alamo A, Amaradio MD, Polosa R: Electronic cigarette: a possible substitute for cigarette dependence. Monaldi Arch Chest Dis 2013, 79(1):12-19.
• [12]Dawkins L, Turner J, Roberts A, Soar K: ‘Vaping’ profiles and preferences: an online survey of electronic cigarette users. Addiction 2013, 108(6):1115-1125.
• [13]Etter JF, Bullen C: Electronic cigarette: users profile, utilization, satisfaction and perceived efficacy. Addiction 2011, 106(11):2017-2028.
• [14]Caponnetto P, Campagna D, Cibella F, Morjaria JB, Caruso M, Russo C, Polosa R: EffiCiency and Safety of an eLectronic cigAreTte (ECLAT) as tobacco cigarettes substitute: a prospective 12-month randomized control design study. PLoS One 2013, 8(6):e66317.
• [15]Bullen C, Howe C, Laugesen M, McRobbie H, Parag V, Williman J, Walker N: Electronic cigarettes for smoking cessation: a randomised controlled trial. Lancet 2013, 382(9905):1629-1637.
• [16]Goniewicz ML, Kuma T, Gawron M, Knysak J, Kosmider L: Nicotine levels in electronic cigarettes. Nicotine Tob Res 2013, 15(1):158-166.
• [17]Dawkins L, Corcoran O: Acute electronic cigarette use: nicotine delivery and subjective effects in regular users. Psychopharmacology (Berl) 2014, 231(2):401-407.
• [18]Farsalinos KE, Spyrou A, Tsimopoulou K, Stefopoulos C, Romagna G, Voudris V: Nicotine absorption from electronic cigarette use: comparison between first and new-generation devices. Sci Rep 2014, 4:4133.
• [19]Fagerstrom KO, Schneider NG: Measuring nicotine dependence: a review of the Fagerstrom Tolerance Questionnaire. J Behav Med 1989, 12(2):159-182.
• [20]Beck A, Ward C, Mendelson M, Mock J, Erbaugh J: Manual for the Beck Depression Inventory. New York: Harcourt Brace Jovanovich; 1987.
• [21]Bolliger CT, Zellweger JP, Danielsson T, van Biljon X, Robidou A, Westin A, Perruchoud AP, Sawe U: Smoking reduction with oral nicotine inhalers: double blind, randomised clinical trial of efficacy and safety. BMJ 2000, 321(7257):329-333.
• [22]Polosa R, Caponnetto P, Morjaria JB, Papale G, Campagna D, Russo C: Effect of an electronic nicotine delivery device (e-Cigarette) on smoking reduction and cessation: a prospective 6-month pilot study. BMC Public Health 2011, 11:786.
• [23]Smith SS, McCarthy DE, Japuntich SJ, Christiansen B, Piper ME, Jorenby DE, Fraser DL, Fiore MC, Baker TB, Jackson TC: Comparative effectiveness of 5 smoking cessation pharmacotherapies in primary care clinics. Arch Intern Med 2009, 169(22):2148-2155.
• [24]Polosa R, Caponnetto P: Advances in Smoking Cessation. London: Future Medicine, Ltd; 2013.
• [25]Wieslander G, Norback D, Lindgren T: Experimental exposure to propylene glycol mist in aviation emergency training: acute ocular and respiratory effects. Occup Environ Med 2001, 58(10):649-655.
• [26]Varughese S, Teschke K, Brauer M, Chow Y, van Netten C, Kennedy SM: Effects of theatrical smokes and fogs on respiratory health in the entertainment industry. Am J Ind Med 2005, 47(5):411-418.
• [27]Fagerstrom KO, Hughes JR, Rasmussen T, Callas PW: Randomised trial investigating effect of a novel nicotine delivery device (Eclipse) and a nicotine oral inhaler on smoking behaviour, nicotine and carbon monoxide exposure, and motivation to quit. Tob Control 2000, 9(3):327-333.
• [28]Bullen C, McRobbie H, Thornley S, Glover M, Lin R, Laugesen M: Effect of an electronic nicotine delivery device (e cigarette) on desire to smoke and withdrawal, user preferences and nicotine delivery: randomised cross-over trial. Tob Control 2010, 19(2):98-103.
• [29]Nutt DJ, Phillips LD, Balfour D, Curran HV, Dockrell M, Foulds J, Fagerstrom K, Letlape K, Milton A, Polosa R, Ramsey J, Sweanor D: Estimating the Harms of Nicotine-Containing Products Using the MCDA Approach. Eur Addict Res 2014, 20(5):218-225.
• [30]Farsalinos KE, Polosa R: Safety evaluation and risk assessment of electronic cigarettes as tobacco cigarettes substitutes: A systematic review. Ther Adv Drug Saf 2014, 5:67-86.
• [31]Farsalinos KE, Romagna G, Tsiapras D, Kyrzopoulos S, Voudris V: Evaluating nicotine levels selection and patterns of electronic cigarette use in a group of “vapers” who had achieved complete substitution of smoking. Subst Abuse 2013, 7:139-146.
• [32]Farsalinos KE, Romagna G, Tsiapras D, Kyrzopoulos S, Spyrou A, Voudris V: Impact of flavour variability on electronic cigarette use experience: an internet survey. Int J Environ Res Public Health 2013, 10(12):7272-7282.
• [33]Polosa R, Rodu B, Caponnetto P, Maglia M, Raciti C: A fresh look at tobacco harm reduction: the case for the electronic cigarette. Harm Reduct J 2013, 10(1):19.
• [34]Caponnetto P, Auditore R, Russo C, Cappello GC, Polosa R: Impact of an electronic cigarette on smoking reduction and cessation in schizophrenic smokers: a prospective 12-month pilot study. Int J Environ Res Public Health 2013, 10(2):446-461.
• [35]Polosa R, Morjaria JB, Caponnetto P, Caruso M, Strano S, Battaglia E, Russo C: Effect of smoking abstinence and reduction in asthmatic smokers switching to electronic cigarettes: evidence for harm reversal (in press). Int J Environ Res Public Health 2014, 11(5):4965-4977.
• [36]Saitta D, Ferro GA, Polosa R: Achieving appropriate regulations for electronic cigarettes. Ther Adv Chronic Dis 2014, 5(2):50-61.