An exploration of flavours in studies of e‐cigarettes for smoking cessation: secondary analyses of a systematic review with meta‐analyses

Lindson, Nicola, Butler, Ailsa, Liber, Alex, Levy, David, Barnett, Phoebe, Theodoulou, Annika, Notley, Caitlin ORCID: https://orcid.org/0000-0003-0876-3304, Rigotti, Nancy and Hartmann-Boyce, Jamie (2022) An exploration of flavours in studies of e‐cigarettes for smoking cessation: secondary analyses of a systematic review with meta‐analyses. Addiction. ISSN 0965-2140

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Abstract

Aims: To estimate associations between e-cigarette flavour and smoking cessation and study product use at 6 months or longer. Methods: Secondary analysis of data from a living systematic review, with meta-analyses and narrative synthesis, incorporating data up to Jan 2022. Included studies provided people who smoked combustible cigarettes with nicotine e-cigarettes for the purpose of smoking cessation, compared with no treatment or other stop smoking interventions. Measurements included smoking cessation and study product use at 6 months or longer reported as risk ratios (RR) with 95% confidence intervals (CI); flavour use at any time points. Results: We included 16 studies (n=10,336); 14 contributed to subgroup analyses and 10 provided participants with a choice of e-cigarette flavour. We judged nine, five and two studies at high, low, and unclear risk of bias, respectively. Subgroup analyses showed no clear associations between flavour and cessation or product use. In all but one analysis tests for subgroup differences resulted in I2 values between 0% and 35%. In the comparison between nicotine e-cigarettes and nicotine replacement therapy (NRT) (I2 =65.2% for subgroup differences), studies offering tobacco flavour e-cigarettes showed evidence of a greater proportion of participants still using at six-months or longer (RR=3.81; 95% CI=1.45 to 10.05; 3 studies; n=1181; I2 =84%), whereas there was little evidence for greater 6-month use when studies offered a choice of flavours (RR=1.44; 95% CI=0.80 to 2.56; 2 studies; n=454; I2 =82%). However, substantial statistical heterogeneity within subgroups makes interpretation of this result unclear. In the 10 studies where participants had a choice of flavours and this was tracked over time some switching between flavours occurred, but there were no clear patterns in flavour preferences. Conclusions: There does not appear to be a clear association between e-cigarette flavours and smoking cessation or longer-term e-cigarette use, possibly due to a paucity of data. There is evidence that people using e-cigarettes to quit smoking switch between e-cigarette flavours.

Item Type: Article
Additional Information: Funding Information: N.A.R. has received royalties from UpToDate, Inc. for chapters on electronic cigarettes. Outside the topic of e‐cigarettes, she has consulted for and received a research grant from Achieve Life Sciences. Funding Information: This work was supported by funding from Cancer Research UK and a University of Oxford Public Policy Challenge Grant. Infrastructure funding for the Cochrane Tobacco Addiction Group is provided by the National Institute for Health and Care Research (NIHR). The views and opinions expressed herein are those of the authors and do not necessarily reflect those of the Systematic Reviews Programme, NIHR, National Health Service (NHS) or the Department of Health. We would like to thank authors who provided data for this analysis: Dr Francesca Pesola, Dr Katie Myers Smith, Professor Kim Pulvers, Dr Paul A. Bateman, Dr Rachna Begh, Dr Pasquale Caponnetto and Professor Riccardo Polosa. Publisher Copyright: © 2022 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.
Uncontrolled Keywords: e-cigarettes,flavours,nicotine,smoking cessation,systematic review,tobacco,medicine (miscellaneous),psychiatry and mental health ,/dk/atira/pure/subjectarea/asjc/2700/2701
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
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Depositing User: LivePure Connector
Date Deposited: 15 Dec 2022 03:54
Last Modified: 03 Jan 2023 10:34
URI: https://ueaeprints.uea.ac.uk/id/eprint/90092
DOI: 10.1111/add.16091

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