Helping the quitters quit: A systematic review and narrative synthesis of the barriers and facilitators to e-cigarette cessation and the support that is needed.

Introduction:
This text is a systematic review and narrative synthesis of the barriers and facilitators to e-cigarette cessation, as well as the support needed for individuals who want to quit. The review highlights the complexities of e-cigarette cessation and the need for tailored support to help individuals quit.

Key Points:

* E-cigarette use is growing around the world, with varying regulations and public health messaging.
* In the UK, e-cigarettes are endorsed as a smoking cessation aid and are increasingly offered by specialist stop smoking services.
* The long-term effects of e-cigarette use on individual's health and tobacco smoking behavior remain unclear.
* The addictive properties of nicotine are well documented.
* E-cigarettes provide consumers with the opportunity to adapt elements of their experience to meet their individual needs.
* A systematic review of prevalence estimates that 5-10% of the general population use e-cigarettes.
* The most common reasons for e-cigarette use among non-smokers are curiosity and use by friends. The primary motivation cited by smokers is to aid smoking cessation or reduction.
* Tobacco smoking represents a significant global challenge and is the principle modifiable risk factor for a wide range of preventable diseases.
* A large UK-based randomised controlled trial demonstrated a 1-year abstinence rate of 18% in the e-cigarette group compared with 9.9% in the NRT group.
* The review identified eight categories of barriers, facilitators, and support needed for e-cigarette cessation, including fear of returning to tobacco, dependency on tobacco, e-cigarettes to reduce stress, health and hazard beliefs, social influences, degree of enjoyment, environmental factors, and cessation support.

Main Message:
The review highlights the need for tailored support for individuals who want to quit e-cigarette use. The barriers and facilitators to e-cigarette cessation are complex and multifaceted, requiring a nuanced understanding of the individual's needs. Healthcare providers and policymakers must consider the unique challenges and opportunities presented by e-cigarette cessation and develop targeted interventions to support individuals in their quit attempts. The long-term effects of e-cigarette use on individual's health and tobacco smoking behavior remain unclear, making it essential to provide support and resources to those who want to quit.

Dyson J, Bhatnagar M, Skinner J, Crooks M. Helping the quitters quit: A systematic review and narrative synthesis of the barriers and facilitators to e-cigarette cessation and the support that is needed. Patient education and counseling. 2022;105(6):1402-1410. doi:10.1016/j.pec.2021.09.024