E Cigarettes Essay
Summary:
Cigarette smoking is a leading cause of death and disability worldwide.(1) Most smokers have tried quitting throughout their life,(2) but often fail because cigarettes contain a highly addictive substance – nicotine. Nicotine replacement therapies (NRTs), such as nicotine patches, are the most successful quitting method, yet fewer than 20% of quitters are successful.(3) Electronic cigarettes (e-cigarettes) may improve this success rate because they tackle addiction as well as associated behaviours. We will assess the effectiveness of e-cigarettes as a quitting aid, by comparing the quitting rate and quitting duration to e-cigarettes without nicotine and to other NRTs. We will also assess if there are side-effects of e-cigarettes by measuring lung capacity. The results of our study will: inform governments about the best quitting methods; improve quitting rates; and reduce the number of deaths and disability caused by smoking. …show more content…
Background:
The Problem:
Tobacco smoking is a leading cause of preventable death worldwide,(1) killing around 15,000 Australians and costing $31 billion every year.(2) Ninety percent of current smokers wish they never started,(4) and 80% have tried to quit.(5) Many of these attempts fail due to a combined effect of nicotine addiction and behavioural reinforcement.(6) An example of these behavioural cues is moving a cigarette to the mouth. NRTs almost double quitting rates,(3) but even then, fewer than 20% of quitters successfully quit after 12 months.(3) These low quitting rates may be because NRTs reduce nicotine dependence but not behavioural cues. E-cigarettes, on the other hand, deliver nicotine to account for nicotine addiction, and resemble a traditional cigarette to account for associated behavioural cues. It has been hypothesised that e-cigarettes are more effective than NRTs at helping people quit smoking, as they deliver nicotine in addition to mirroring the behavioural cues of smoking.(6,7) Self-reported quit rates and observational studies suggest e-cigarettes are good potential quitting aids,(8) yet relatively few RCTs have been conducted.
Past Research:
E-cigarettes are often promoted as quitting aids, but there is much controversy regarding their effectiveness.(8,9) Previous RCTs and population-based longitudinal studies have not found any associations between e-cigarette use and quitting.(8,9) However, these studies often lack detailed data on e-cigarette use, such as frequency, duration, or motivation for use.(10) Furthermore, the data were often self-reported.(10) As such, these studies may not have information on key confounders, and may be subject to biases, such as recall bias.
A recent study found 48.5 million Europeans have tried e-cigarettes.(11) Among the 7.5 million current users, 35.1% have quit smoking and a further 32.2% have reduced their consumption.(11) This study has a very large sample size from 28 countries, so the results indicare a positive impact of e-cigarettes on quitting. However, as an observational study, there is an inherent risk that bias may influence results. As such, we aim to reproduce these results using a RCT.
Current
Controversies:
There are two major claims for the use of e-cigarettes as a quitting aid.(12) Firstly, it is suggested they increase quitting success.(12) However, as alluded to above, there is limited evidence on whether e-cigarettes assist quitting. Secondly, it is suggested e-cigarettes are safer to use in the long term than standard cigarettes.(12) The long-term effects are also unknown, but they are probably less severe than those of standard cigarettes.(12) This is because e-cigarettes do not contain toxic compounds, or contain them at much lower levels than in cigarettes.(13) Since there are still many controversies regarding the use of nicotine in e-cigarettes, the Australian Government currently bans their use,(14) except where a nicotine e-cigarette is for therapeutic uses, such as smoking cessation. In this case, e-cigarettes are legal if registered with the Therapeutic Goods Administration,(14-16) and the nicotine is prescribed by a medical practitioner.(14,17)
Research Question(s):
Do nicotine e-cigarettes improve quitting success in current smokers wanting to quit compared to placebo e-cigarettes or NRT over one year follow-up?
Is there are negative impact of nicotine e-cigarettes on the lung function of current smokers wanting to quit, when compared to placebo e-cigarettes or NRT over one year?
Cigarette smoking is a leading cause of death and disability worldwide.(1) Most smokers have tried quitting throughout their life,(2) but often fail because cigarettes contain a highly addictive substance – nicotine. Nicotine replacement therapies (NRTs), such as nicotine patches, are the most successful quitting method, yet fewer than 20% of quitters are successful.(3) Electronic cigarettes (e-cigarettes) may improve this success rate because they tackle addiction as well as associated behaviours. We will assess the effectiveness of e-cigarettes as a quitting aid, by comparing the quitting rate and quitting duration to e-cigarettes without nicotine and to other NRTs. We will also assess if there are side-effects of e-cigarettes by measuring lung capacity. The results of our study will: inform governments about the best quitting methods; improve quitting rates; and reduce the number of deaths and disability caused by smoking. …show more content…
Background:
The Problem:
Tobacco smoking is a leading cause of preventable death worldwide,(1) killing around 15,000 Australians and costing $31 billion every year.(2) Ninety percent of current smokers wish they never started,(4) and 80% have tried to quit.(5) Many of these attempts fail due to a combined effect of nicotine addiction and behavioural reinforcement.(6) An example of these behavioural cues is moving a cigarette to the mouth. NRTs almost double quitting rates,(3) but even then, fewer than 20% of quitters successfully quit after 12 months.(3) These low quitting rates may be because NRTs reduce nicotine dependence but not behavioural cues. E-cigarettes, on the other hand, deliver nicotine to account for nicotine addiction, and resemble a traditional cigarette to account for associated behavioural cues. It has been hypothesised that e-cigarettes are more effective than NRTs at helping people quit smoking, as they deliver nicotine in addition to mirroring the behavioural cues of smoking.(6,7) Self-reported quit rates and observational studies suggest e-cigarettes are good potential quitting aids,(8) yet relatively few RCTs have been conducted.
Past Research:
E-cigarettes are often promoted as quitting aids, but there is much controversy regarding their effectiveness.(8,9) Previous RCTs and population-based longitudinal studies have not found any associations between e-cigarette use and quitting.(8,9) However, these studies often lack detailed data on e-cigarette use, such as frequency, duration, or motivation for use.(10) Furthermore, the data were often self-reported.(10) As such, these studies may not have information on key confounders, and may be subject to biases, such as recall bias.
A recent study found 48.5 million Europeans have tried e-cigarettes.(11) Among the 7.5 million current users, 35.1% have quit smoking and a further 32.2% have reduced their consumption.(11) This study has a very large sample size from 28 countries, so the results indicare a positive impact of e-cigarettes on quitting. However, as an observational study, there is an inherent risk that bias may influence results. As such, we aim to reproduce these results using a RCT.
Current
Controversies:
There are two major claims for the use of e-cigarettes as a quitting aid.(12) Firstly, it is suggested they increase quitting success.(12) However, as alluded to above, there is limited evidence on whether e-cigarettes assist quitting. Secondly, it is suggested e-cigarettes are safer to use in the long term than standard cigarettes.(12) The long-term effects are also unknown, but they are probably less severe than those of standard cigarettes.(12) This is because e-cigarettes do not contain toxic compounds, or contain them at much lower levels than in cigarettes.(13) Since there are still many controversies regarding the use of nicotine in e-cigarettes, the Australian Government currently bans their use,(14) except where a nicotine e-cigarette is for therapeutic uses, such as smoking cessation. In this case, e-cigarettes are legal if registered with the Therapeutic Goods Administration,(14-16) and the nicotine is prescribed by a medical practitioner.(14,17)
Research Question(s):
Do nicotine e-cigarettes improve quitting success in current smokers wanting to quit compared to placebo e-cigarettes or NRT over one year follow-up?
Is there are negative impact of nicotine e-cigarettes on the lung function of current smokers wanting to quit, when compared to placebo e-cigarettes or NRT over one year?