DETERMINING THE DIFFERENCES BETWEEN THE RATES OF SMOKING CESSATION USING E-CIGARETTES VS NICOTINE-REPLACEMENT THERAPY: A META-ANALYSIS AND SYSTEMATIC REVIEW OF RANDOMIZED CONTROLLED TRIALS

Iqra Ayesha Jawad; Aqsa Ayesha Masood; Muhammad Zeeshan Ali; Jawad Safdar

doi:10.46903/gjms/23.1.1683

DETERMINING THE DIFFERENCES BETWEEN THE RATES OF SMOKING CESSATION USING E-CIGARETTES VS NICOTINE-REPLACEMENT THERAPY: A META-ANALYSIS AND SYSTEMATIC REVIEW OF RANDOMIZED CONTROLLED TRIALS

Iqra Ayesha Jawad, Aqsa Ayesha Masood, Muhammad Zeeshan Ali, Jawad Safdar

Abstract

Both e-cigarettes (electronic cigarettes) and nicotine-replacement therapy (NRT) are employed to help people quit smoking, though some healthcare professionals still approach e-cigarettes with caution. This review aimed to compare their effectiveness for short- and long-term cessation. Studies were searched in MEDLINE and The Cochrane Central Register of Controlled Trials (CENTRAL), focusing on randomized trials involving participants in the contemplation stage of quitting. The review assessed NRT and e-cigarettes, primarily evaluating dichotomous quitting rates one year after cessation and data was rated using GRADE. The review included six RCTs with 1883 participants; 943 control group and 940 intervention group with a median age of 41.5 years. We observed that e-cigarettes increased the rate of 7-day point abstinence at 6 months or longer to 28% compared to 20% for NRT, with an RR of 1.43 and a 95% CI ranging from 1.19 to 1.72, though with low certainty. E-cigarettes did not offer significant improvements in 7-day point abstinence rates at 3 to 6 months, with rates of 22% compared to 21% for NRT and an RR of 1.01, along with a 95% CI between 0.70 and 1.44, showing low certainty. Similarly, there were no notable benefits at less than 3 months, where the abstinence rate was 38% compared to 29%, with an RR of 1.19 and a 95% CI from 0.92 to 1.54, also with low certainty. E-cigarettes did, however, show an increase in the persistent smoking cessation rate at 6 months or more, with an RR of 1.67 and a 95% CI ranging from 1.24 to 2.25, though this was determined with very low certainty. No significant benefits were observed for persistent smoking cessation at less than 3 months, where the RR was 1.37 with a 95% CI between 1.19 and 1.58, or at 3 to 6 months, where the RR was 1.12 with a 95% CI interval from 0.84 to 1.5, also with very low certainty. E-cigarettes were superior to NRT for both primary and secondary outcomes at ≥6 months, but no evidence supported their superiority at <6 months. Future research should investigate the both long-term safety and efficacy of e-cigarettes versus NRT across diverse populations and conditions.

Keywords

Nicotine; Replacement; Therapy; Electronic; Cigarette; Smoking; cessation.

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DOI: https://doi.org/10.46903/gjms/23.1.1683