The potential of new nicotine and tobacco products as tools for people who smoke to quit combustible cigarettes - a systematic review of common practices and guidance towards a robust study protocol to measure cessation efficacy.

IF 4 2区 社会学 Q1 SUBSTANCE ABUSE
Nikola Pluym, Therese Burkhardt, Gerhard Scherer, Max Scherer
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Abstract

New types of nicotine and tobacco products like electronic cigarettes (ECs), heated tobacco products or nicotine pouches have been discussed as less harmful alternatives to combustible cigarettes and other toxic forms of tobacco products. Their harm reduction potential lay in the efficient transition away from smoking to those new products. Numerous studies addressing the cessation efficacy of ECs have been published with contradictory outcomes. Yet, a comprehensive Cochrane review concluded with high certainty on the cessation efficacy of ECs. This prompted us to perform a review to identify weaknesses in common study designs and to summarize best practices for the study design on the potential of new nicotine products as cessation aids. 120 articles retrieved from Medline were found to be eligible. Most of the studies in the field were interventional trials while observational studies played a minor role in the evaluation of smoking cessation. Efficacy was predominantly assessed for ECs in 77% of the reports while heated tobacco (17%) and non-combustible products (11%) were less frequently investigated up to now. Measures to determine the efficacy were questionnaire-based assessments as well as use documentation/prevalence and abstinence rates. Studies varied largely in their duration and sample size with medians of 3 months and 156.5 participants, respectively.With the help of this review, we identified several weaknesses in the common study designs. One major limitation in longitudinal trials was the lack of compliance measures suited to verify the use status over longer time periods, relying solely on self-reports. Moreover, the motivation of the participants to quit was rarely defined and a profound familiarization period was not taken into account for the majority of the studies. To what extent such weaknesses influence the outcome of the studies was beyond the scope of this review. We encourage researchers to consider the recommendations which resulted from this review in order to determine the abuse liability and cessation efficacy of the products in a more robust manner. Finally, we like to call attention to the missing data for low- and middle-income countries which would require quitting strategies most urgently to combat the tobacco smoking epidemic.

新型尼古丁和烟草产品作为吸烟者戒除可燃卷烟的工具的潜力--对常见做法的系统性回顾,以及对衡量戒烟效果的可靠研究方案的指导。
新型尼古丁和烟草制品,如电子香烟(EC)、加热烟草制品或尼古丁袋,作为可燃香烟和其他有毒烟草制品的危害较小的替代品,已经引起了讨论。其减少危害的潜力在于有效地从吸烟过渡到这些新产品。针对电子烟戒烟效果的研究成果层出不穷,但结果却相互矛盾。然而,一项全面的科克伦综述对电子烟的戒烟效果做出了高度肯定的结论。这促使我们进行了一项综述,以找出常见研究设计中的不足之处,并总结出有关新型尼古丁产品作为戒烟辅助工具的潜力的最佳研究设计实践。从 Medline 上检索到 120 篇符合条件的文章。该领域的大多数研究都是介入性试验,而观察性研究在戒烟评估中的作用较小。在77%的报告中,主要评估了电子烟的疗效,而加热烟草(17%)和非燃烧产品(11%)的研究则较少。确定疗效的措施包括问卷评估以及使用记录/流行率和戒断率。这些研究的持续时间和样本量大不相同,中位数分别为 3 个月和 156.5 人。纵向试验的一个主要限制因素是缺乏适合在较长时间内验证使用状况的依从性测量方法,只能依靠自我报告。此外,大多数研究很少界定参与者的戒烟动机,也没有考虑到深刻的熟悉期。这些缺陷对研究结果的影响程度超出了本综述的范围。我们鼓励研究人员考虑本综述提出的建议,以便以更稳健的方式确定产品的滥用责任和戒烟功效。最后,我们希望提请注意中低收入国家数据的缺失,这些国家迫切需要戒烟策略来应对烟草流行。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Harm Reduction Journal
Harm Reduction Journal Medicine-Public Health, Environmental and Occupational Health
CiteScore
5.90
自引率
9.10%
发文量
126
审稿时长
26 weeks
期刊介绍: Harm Reduction Journal is an Open Access, peer-reviewed, online journal whose focus is on the prevalent patterns of psychoactive drug use, the public policies meant to control them, and the search for effective methods of reducing the adverse medical, public health, and social consequences associated with both drugs and drug policies. We define "harm reduction" as "policies and programs which aim to reduce the health, social, and economic costs of legal and illegal psychoactive drug use without necessarily reducing drug consumption". We are especially interested in studies of the evolving patterns of drug use around the world, their implications for the spread of HIV/AIDS and other blood-borne pathogens.
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