Longer-term use of electronic cigarettes when provided as a stop smoking aid: Systematic review with meta-analyses.

Introduction:
This summary will provide an overview of a study examining the use of electronic cigarettes (e-cigarettes) as a smoking cessation aid. The study includes a systematic review and meta-analyses of the proportion of people still using e-cigarettes or other study products at 6 months or longer. The study also compares long-term use of nicotine e-cigarettes with non-nicotine e-cigarettes and other treatments.

Key Points:

* The study included 19 studies with a total of 7787 participants.
* The pooled prevalence of continued e-cigarette use at 6 months or longer was 54% (95% CI: 46% to 61%, I2 86%).
* Of participants who had quit combustible cigarettes overall, 70% were still using e-cigarettes at six months or longer (95% CI: 53% to 82%, I2 73%).
* Heterogeneity in direction of effect precluded meta-analysis comparing long-term use of nicotine e-cigarettes with NRT.
* More people were using nicotine e-cigarettes at longest follow-up compared to non-nicotine e-cigarettes (risk ratio 1.15, 95% CI: 0.94 to 1.41).
* The levels of continued e-cigarette use observed may reflect the success of e-cigarettes as a quitting tool.
* Further research is needed to establish drivers of variation in and implications of continued use of e-cigarettes.

Main Message:
The study provides moderate certainty evidence that e-cigarettes can be an effective smoking cessation aid, with a high proportion of participants still using e-cigarettes at 6 months or longer. However, there is less certainty regarding how long people continue to use e-cigarettes after smoking cessation attempts. The study highlights the need for further research to establish the drivers of variation in and implications of continued use of e-cigarettes. Overall, the findings support the use of e-cigarettes as a harm reduction tool for smoking cessation, but also emphasize the importance of monitoring long-term use and its potential health implications.

Butler AR, Lindson N, Fanshawe TR, et al. Longer-term use of electronic cigarettes when provided as a stop smoking aid: Systematic review with meta-analyses. Preventive medicine. 2022;165:107182. doi:10.1016/j.ypmed.2022.107182