背景:本系统评价旨在确定电子烟(电子烟)作为成人(≥18岁)的戒烟辅助手段的益处和危害,并为加拿大预防保健工作组(CTFPHC)关于电子烟的临床实践指南的制定提供信息。
方法:我们搜索了OvidMEDLINE®,OvidMEDLINE®Epub提前打印,过程中和其他非索引引文,PsycINFO,Embase经典+Embase,还有Wiley上的Cochrane图书馆.搜索于2016年1月至2019年7月进行,并于2020年9月24日和2024年1月25日更新。两名评审员根据预先确定的纳入标准独立进行标题摘要和全文筛选。数据提取,质量评估,以及建议评估分级的应用,开发和评估(等级)由一个独立的审阅者进行,并由另一个独立的审阅者进行验证。
结果:我们在17项随机对照试验中确定了18项研究,这些研究将含尼古丁的电子烟与不含尼古丁的电子烟以及电子烟(含或不含尼古丁)与其他干预措施(即,没有干预,候补名单,标准/常规护理,退出建议,或行为支持)。考虑到电子烟在戒烟和减少吸烟频率方面的好处,14项研究表明,与其他干预措施相比,含或不含尼古丁的电子烟的益处较小或中等;尽管,低,非常低或中等的证据确定性。特别关注含有尼古丁的电子烟,12项研究表明,与常规护理或非尼古丁电子烟相比,戒烟有好处。在使用尼古丁或非尼古丁电子烟后的危害方面,15项研究报告了轻度不良事件,组间几乎没有差异,证据确定性低至非常低。
结论:关于电子烟有效性的综合证据表明,围绕益处的数据对某些比较具有低至中等的证据确定性,对其他比较具有非常低的确定性,表明电子烟可能或可能会增加戒烟,然而,对于危害,证据的确定性很低,甚至很低。由于不同研究的结果测量持续时间不同,不良事件(AE)的出现可能不够长期,并且需要更多的研究来了解电子烟的长期益处和潜在危害。
背景:PROSPEROCRD42018099692.
BACKGROUND: This systematic review aims to identify the benefits and harms of electronic cigarettes (e-cigarettes) as a smoking cessation aid in adults (aged ≥ 18 years) and to inform the development of the Canadian Task Force on Preventive Health Care\'s (CTFPHC) clinical practice guidelines on e-cigarettes.
METHODS: We searched Ovid MEDLINE®, Ovid MEDLINE® Epub Ahead of Print, In-Process & Other Non-Indexed Citations, PsycINFO, Embase Classic + Embase, and the Cochrane Library on Wiley. Searches were conducted from January 2016 to July 2019 and updated on 24 September 2020 and 25 January 2024. Two reviewers independently performed title-abstract and full-text screening according to the pre-determined inclusion criteria. Data extraction, quality assessments, and the application of Grading of Recommendations Assessment, Development and Evaluation (GRADE) were performed by one independent reviewer and verified by another.
RESULTS: We identified 18 studies on 17 randomized controlled trials that compared e-cigarettes with nicotine to e-cigarettes without nicotine and e-cigarettes (with or without nicotine) to other interventions (i.e., no intervention, waitlist, standard/usual care, quit advice, or behavioral support). Considering the benefits of e-cigarettes in terms of smoking abstinence and smoking frequency reduction, 14 studies showed small or moderate benefits of e-cigarettes with or without nicotine compared to other interventions; although, with low, very low or moderate evidence certainty. With a focus on e-cigarettes with nicotine specifically, 12 studies showed benefits in terms of smoking abstinence when compared with usual care or non-nicotine e-cigarettes. In terms of harms following nicotine or non-nicotine e-cigarette use, 15 studies reported mild adverse events with little to no difference between groups and low to very low evidence certainty.
CONCLUSIONS: The evidence synthesis on the e-cigarette\'s effectiveness shows data surrounding benefits having low to moderate evidence certainty for some comparisons and very low certainty for others, indicating that e-cigarettes may or probably increase smoking cessation, whereas, for harms, there is low to very low evidence certainty. Since the duration for outcome measurement varied among different studies, it may not be long-term enough for Adverse Events (AEs) to emerge, and there is a need for more research to understand the long-term benefits and potential harms of e-cigarettes.
BACKGROUND: PROSPERO CRD42018099692.