E cigarettes for the management of nicotine addiction
In this review, we discuss current evidence on electronic cigarettes (ECs) a rapidly evolving class of nicotine delivery system, and their role in managing nicotine addiction, specifically in helping smokers to quit smoking and/or reduce the amount of tobacco they smoke. The current evidence base is limited to three randomized trials (only one compares ECs with nicotine replacement therapy) and a growing number of EC user surveys (n=6) case reports (n=4) and cohort studies (n=8) Collectively, these studies suggest modest cessation efficacy and a few adverse effects, at least with the short term use. On this basis, we provide advice for health care providers on providing balanced information for patients who enquire about ECs. More research, specifically well conducted large efficacy trials comparing ECs with standard smoking cessation management (eg, nicotine replacement therapy plus behavioral support) and long term prospective studies for adverse events, are urgently needed to fill critical knowledge gaps on these products.
Substance abuse and rehabilitation