Nicotine-Free E-Cigarettes Might Promote Tobacco Smoking Reduction Better Than Nicotine Delivery Devices: Results of a Double-Blind Randomized Controlled Trial at 1 Year.

Introduction:
This summary will provide an overview of a study examining the impact of e-cigarettes on smoking-related respiratory symptoms and smoking cessation rates in chronic smokers. The study is a double-blind, randomized, controlled trial with a one-year follow-up.

Key Points:

* The study enrolled 210 chronic smokers who were divided into three arms: nicotine e-cigarettes, nicotine-free e-cigarettes, and a control group receiving only psychological counseling.
* The primary outcome measured was the improvement in pulmonary health, while the secondary outcomes included the assessment of smoking cessation attempts and daily smoking reduction in the three arms.
* The study found that participants who used nicotine-free e-cigarettes had a higher quitters' rate at month 3, but both nicotine and nicotine-free e-cigarette groups experienced an increased tendency to relapse at month 6 and 12.
* Participants who vaped nicotine-free e-cigarettes experienced a higher reduction in daily cigarette consumption.
* The study also found that physical and psychological variables, such as baseline dependence level, number of daily cigarettes, and anxiety level, were positively associated with the number of daily cigarettes at 1 year.
* The study did not observe any severe side-effects during the whole study, and the main side-effect reported was burning throat, which decreased from month 6 to month 12.
* The outcomes suggest that more focused research is needed to define policies for stakeholders and clinical guidelines for healthcare professionals to properly approach the huge problem of tobacco smoking.

Main Message:
The study suggests that while e-cigarettes may be safe and valid tools to help smokers stop or reduce tobacco consumption, more variables beyond the choice of a specific nicotine delivery system play important roles in an anti-smoking setting. The study highlights the key role of psychological intervention in tobacco smoking cessation programs and the importance of considering several methodological, contextual, and individual concerns when evaluating e-cigarettes' efficacy as anti-smoking tools.

Lucchiari C, Masiero M, Mazzocco K, et al. Nicotine-Free E-Cigarettes Might Promote Tobacco Smoking Reduction Better Than Nicotine Delivery Devices: Results of a Double-Blind Randomized Controlled Trial at 1 Year. Current oncology (Toronto, Ont). 2022;29(11):8579-8590. doi:10.3390/curroncol29110676