Electronic cigarettes versus nicotine-replacement therapy for smoking cessation: a systematic review and meta-analysis of randomized controlled trials.

Introduction:
This summary will provide an overview of a study that compares the effectiveness and safety of electronic cigarettes (e-cigarettes) and nicotine-replacement therapy (NRT) for smoking cessation. The study is a systematic review and meta-analysis of randomized controlled trials.

Key Points:

* The study included five randomized controlled trials with a total of 1748 participants.
* The meta-analysis suggested that e-cigarettes increased the ≥6 months continuous abstinence rate (RR=1.67; 95% CI: 1.21--2.28) and 7-day point abstinence rate at ≥6 months follow-up (RR=1.43; 95% CI: 1.19--1.72) compared to NRT.
* however, there was no evidence that e-cigarettes increased the 3--6 months continuous abstinence rate (RR=1.07; 95% CI: 0.73--1.57) and <3 months continuous abstinence rate (RR=1.20; 95% CI: 0.90--1.60) compared to NRT.
* The adverse events were not significant between e-cigarettes and NRT other than throat irritation (RR=1.27; 95% CI: 1.13--1.42).
* The study also found that e-cigarettes appeared to be superior to NRT in ≥6 months continuous abstinence rate and 7-day point abstinence rate.
* at short-term duration, there was no evidence that e-cigarettes compared to NRT increased the <6 months continuous abstinence rate and 7-day point abstinence rate.
* The paucity of reliable research decreases the confidence in the results.

Main Message:
The main message of this study is that e-cigarettes appeared to be superior to NRT in helping smokers quit at long-term duration, but at short-term duration, there was no evidence that e-cigarettes compared to NRT increased the quit rate. however, the study also noted that the paucity of reliable research decreases the confidence in the results. It is important to balance the benefits and harms of e-cigarettes and NRT before making decisions, and further studies are required to address the issue of the harms between e-cigarettes and NRT. additionally, policymakers should also consider cost-effectiveness analysis and strengthen the regulation of e-cigarettes due to the increasing use among adolescents and young adults and the potential health risks associated with dual use.

Li J, hui X, Fu J, ahmed MM, Yao L, Yang K. Electronic cigarettes versus nicotine-replacement therapy for smoking cessation: a systematic review and meta-analysis of randomized controlled trials. Tobacco induced diseases. 2022;20:90. doi:10.18332/tid/154075