Smoking Cessation Aid Research Articles

Marketing claims on the websites of leading e-cigarette brands in England

IntroductionExposure to electronic cigarette (EC) marketing is associated with EC use, particularly among youth. In England, the Tobacco and Related Products Regulations and Committee of Advertising Practice (CAP) regulate EC...

Use of Vaping as a Smoking Cessation Aid: A Review of Clinical Trials.

Smoking is a global public health concern, with a significant negative impact on human health and healthcare spending. Vaping, or the use of electronic cigarettes (e-cigarettes), has emerged as a popular alternative to traditional nicotine replacement therapies (NRTs) for smoking cessation. While considered less harmful than combustible cigarettes, the long-term health effects of e-cigarettes (vaping) are unknown. Therefore, this study aimed to identify and provide a comprehensive overview of the performance of vaping in clinical trials. A search was conducted in the ClinicalTrials.gov database on April 14th, 2023, using the search term "smoking cessation, e-cigarettes, NRTs, and vaping". Inclusion and exclusion criteria were defined to identify relevant clinical trials. Randomized controlled trials (RCTs) and non-randomized clinical trials that evaluated vaping as a therapeutic approach to smoking cessation were included. A total of 87 clinical trials were identified, of which only seven were related to smoking cessation through vaping as a form of treatment. The primary endpoint was the effect of vaping as smoking cessation, and the secondary endpoints were patients' abstinence rate, withdrawal symptoms, and adverse events of e-cigarettes. Most of the trials used e-cigarettes as an intervention, with some trials including a combination of e-cigarettes and other NRTs. The trials lasted from 4 weeks to 12 months. The overall results of the trials indicated that vaping was effective in helping smokers to quit. It was also associated with a lower risk of adverse events than combustible cigarettes. Vaping appears to be an effective method for smoking cessation, and it is associated with a lower risk of adverse events than combustible cigarettes.

Development of inhalation exposure system for assessing respiratory safety of nicotine-free inhalator as nonignition smoking cessation aid

In this study, we aimed to develop and evaluate an inhalation exposure system involving vapor generation for a nonignition smoking cessation aid, a nicotine-free inhalator, with the objective of assessing its respiratory safety by obtaining inhalation safety data. The vapor was generated by blowing air into the raw material of the inhalator, and the vapor concentration was controlled by adjusting the inhalation exposure conditions: the amount of raw material (5, 50, and 100 g), flow rate (0.1, 1, and 2 L min−1), and temperature (25, 40, and 80 °C). We evaluated the effectiveness of the inhalation exposure system by examining the generated concentrations of the main component in the vapor of the nicotine-free inhalator, L-menthol, the concentration of which varied based on inhalation exposure conditions. This concentration of L-menthol proportionally increased with increasing amounts of raw material (slope = 0.4625 mg m−3 g−1 and R2 = 0.9763). The concentration of L-menthol in the vapor increased as the generation flow rate decreased and remained at a relatively consistent level for the 6 h necessary for inhalation toxicity assessment (–79.38 mg m−3 L–1 min and R2 = 0.9262). The L-menthol concentration in the vapor increased by approximately five times when the generation temperature was increased from 25 °C to 80 °C. However, the change in the L-menthol concentration in the vapor after 6 h was substantial, ranging from 20% to 50%. In other words, the generated concentration of vapor is temperature-sensitive, so producing a constant concentration level would be challenging. By adjusting the amount of raw material and generation flow rate of this nicotine-free inhalator, we obtained a vapor sample for the respiratory safety assessment of nonignition smoking cessation aids.

Antenatal interventions to address harmful behaviors and psychosocial risk factors in the prevention of low birth weight

BackgroundRisk factors related to the harmful behaviors, psychosocial wellbeing, and socio-economic circumstances in the lives of pregnant women can lead to adverse birth outcomes, including low birth weight (LBW). ObjectiveThis systematic search and review aims to provide a comparative evidence synthesis on the effect of eleven antenatal interventions targeted to address psychosocial risk factors on adverse birth outcomes. MethodsWe searched MEDLINE, Embase, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials and CINAHL Complete between March 2020 and May 2020. We included randomized controlled trials (RCTs) and reviews of RCTs of eleven antenatal interventions for pregnant females reporting LBW, preterm birth (PTB), small-for-gestational-age or stillbirth as outcomes. For interventions where randomization was either not feasible or unethical, we accepted non-randomized controlled studies. ResultsSeven records contributed data to the quantitative estimates of the effect sizes and 23 contributed to narrative analysis. Psychosocial interventions for reducing smoking in pregnancy likely reduced the risk of LBW, and professionally provided psychosocial support for at-risk women possibly reduced the risk of PTB. Financial incentives or nicotine replacement therapy as smoking cessation aids, or virtually delivered psychosocial support did not appear to reduce the risk of adverse birth outcomes. The available evidence on these interventions was primarily from high-income countries. For other reviewed interventions (psychosocial interventions to reduce alcohol use, group based psychosocial support programs, intimate partner violence prevention interventions, antidepressant medication, and cash transfers) there was little evidence in any direction regarding the efficacy or the data was conflicting. ConclusionsProfessionally provided psychosocial support during pregnancy in general and specifically as a means to reduce smoking can potentially contribute to improved newborn health. The gaps in the investments for research and implementation of psychosocial interventions should be addressed to better meet the global targets in LBW reduction.

Quit smoking: methods and outcomes for Norwegian adults

BackgroundTobacco smoking still represents one of the most significant preventable causes of death and poor health, and higher success rates for people trying to quit smoking would benefit both public and individual health. Achieving this requires better knowledge of factors that might improve the chances of successful quitting. This study aims to investigate cessation activities and explore associations between outcomes of smoking cessation attempts and use of cessation aids, previous cessation attempts, and attempt-planning.MethodsUsing data from a national web panel (N = 1424), smoking cessation activities and use of smoking cessation aids by people who smoke or have smoked are studied bivariately and in adjusted models.ResultsAlmost half the sample had not used a cessation aid in the last quit attempt. Snus was the most common cessation aid, followed by NRTs and ECs. In adjusted models, snus use increased the likelihood of quitting. Planning an attempt and earlier quit attempts were associated with less quitting.ConclusionPresently, switching to snus seems to be the most effective and efficacious method for quitting smoking in Norway.

Antidepressants for smoking cessation.

Antidepressants for smoking cessation.

New medications development for smoking cessation

Diseases associated with nicotine dependence in the form of habitual tobacco use are a major cause of premature death in the United States. The majority of tobacco smokers will relapse within the first month of attempted abstinence. Smoking cessation agents increase the likelihood that smokers can achieve long-term abstinence. Nevertheless, currently available smoking cessation agents have limited utility and fail to prevent relapse in the majority of smokers. Pharmacotherapy is therefore an effective strategy to aid smoking cessation efforts but considerable risk of relapse persists even when the most efficacious medications currently available are used. The past decade has seen major breakthroughs in our understanding of the molecular, cellular, and systems-level actions of nicotine in the brain that contribute to the development and maintenance of habitual tobacco use. In parallel, large-scale human genetics studies have revealed allelic variants that influence vulnerability to tobacco use disorder. These advances have revealed targets for the development of novel smoking cessation agents. Here, we summarize current efforts to develop smoking cessation therapeutics and highlight opportunities for future efforts.

Common adverse events of electronic cigarettes compared with traditional nicotine replacement therapies: A systematic review and meta-analysis.

Established literature suggests that electronic cigarettes (EC) are more effective than traditional nicotine replacement therapies (NRT) as a smoking cessation aid, but the factors that mediate this difference remain poorly understood. We examine how adverse events (AE) associated with EC use relative to NRTs differ, with the view that differences in AEs experienced may drive differences in use and compliance. Papers for inclusion were identified via a three-tiered search strategy. Eligible articles involved healthy participants and compared nicotine ECs to non-nicotine ECs or NRTs and reported frequency of AE as an outcome. Random-effects meta-analyses were conducted to compare the likelihood for each of the AEs between nicotine ECs, non-nicotine placebo ECs and NRTs. A total of 3756 papers were identified, of which 18 were meta-analysed (10 cross-sectional and 8 randomised controlled trials). Meta-analytic results found no significant difference in the rates of reported AEs (i.e., cough, oral irritation, nausea) between nicotine ECs and NRTs, and between nicotine and non-nicotine placebo ECs. The variation in the incidence of AEs likely does not explain user preferences of ECs to NRTs. Incidence of common AEs reported because of EC and NRT use did not differ significantly. Future work will need to quantify both the adverse and favourable effects of ECs to understand the experiential mechanisms that drive the high uptake of nicotine ECs relative to established NRTs. There is inconclusive evidence on the incidence of AEs experience when using ECs compared to NRTs, possibly given the small sample size of studies.

Vaping, an emerging public health concern in South Asia: a short communication.

Electronic cigarettes, or "vaping," are battery-operated devices that heat a liquid containing propylene glycol, nicotine, and some flavoring agents, which aerosolize to produce vapors that the user inhales. They were introduced in 2003 and became popular worldwide as a less irritating alternative to combustible cigarettes. While they were initially advertised as smoking cessation aids, their use has taken the shape of an epidemic in some regions of the world. Vaping prevalence is high in South Asia, where a significant number of people use tobacco and smokeless tobacco. According to data from Pakistan, 6.2% of the population uses vaping/e-cigarettes, while 15.9 million (12.4%) use smokeless tobacco. Vaping may be a safer alternative to cigarette smoking, as e-cigarettes do not contain all the toxins that regular cigarettes do, and the aerosol from e-cigarettes has no appreciable cytotoxic, genotoxic, or inflammatory effects when inhaled. However, nicotine addiction is a concern, as it is the main culprit behind smoking addiction, and e-cigarettes may become a new pathway toward nicotine addiction. Hence, their effectiveness in smoking cessation is still debatable, and their role as a tool for smoking cessation needs further research.

Acute Influence of Moderate Exercise on Smoking Urge, Mood, and Physical Withdrawal Symptoms

Background and Objectives: The potential role of exercise as an aid to conventional smoking-cessation measures is being increasingly suggested. The present study was conducted with the aim of assessing and comparing the influence of short-duration, moderate-intensity exercise on the urge to smoke, and mood and physical withdrawal symptoms among male smokers following an overnight temporary abstinence from smoking with those who smoked ad-libitum. Methods: Thirty male smokers between 18 and 45 years, who smoked >10 cigarettes/day for >1 year were recruited and randomized into two different groups (n = 15 in each group). The abstinent group included smokers who had at least 10 hours of overnight temporary abstinence from smoking on test day. The non-abstinent group included smokers who smoked ad libitum without having any temporary abstinence from smoking on test day. Nicotine dependence, smoking-urge, and withdrawal symptoms were assessed using the Fagerström test for nicotine dependence (FTND), brief questionnaire on smoking-urge (QSU-Brief), and the mood and physical symptom scale (MPSS), respectively. All subjects in both groups performed moderate-intensity exercise on a friction-type bicycle-ergometer at a fixed frictional force of 2 kg for 5 minutes at 40-60% of heart-rate reserve. QSU-Brief and MPSS were assessed pre-exercise and post-exercise (immediately, 5 and 10 minutes after stoppage of exercise). Results: QSU-brief and MPSS scores were comparable in both groups at all time points (P > 0.05). There was a significant decline (P < 0.001) in QSU-brief and MPSS scores immediately following exercise in both groups, which persisted after 5 (P < 0.001) and 10 minutes post-exercise (P < 0.01). Interpretation and Conclusions: Our results indicate that a single session of short-duration, moderate-intensity exercise effectively alleviated the smoking urge and negative effects of nicotine withdrawal symptoms in both study groups and led to an overall improvement in their mood. The results further indicated that these beneficial roles of exercise persisted even after a 10 minutes of stoppage of physical activity. We recommend the incorporation of a brief session of moderate exercise as a smoking cessation aid to provide additive relief from cigarette cravings and nicotine withdrawal symptoms in smokers attempting to quit.

Are Perceived Benefits of Heated Tobacco Products Consumption Aiding Smoking Cessation?

Background The tobacco industry has been facing several transformations, considering that technology has evolved and health concerns have increased. One way for this industry to meet the growing social and health concerns is to provide alternative solutions. Heated tobacco products (HTPs) were the solution found, but they nevertheless pose several challenges to regulators, companies, and consumers, since HTPs are advertised as a less harmful alternative to conventional cigarettes. Focus of the Article This study aims to analyze smokers' perception of HTPs to provide insights for social marketing campaigns targeting behavioral change. Research questions The main objectives of this research are: (1) to assess whether smokers and ex-smokers view HTPs as less harmful to health than traditional cigarettes; and (2) to determine to what extent HTPs can help increase the intention to quit smoking. Methods This study explores smokers’ perception of HTPs consumption using a modified version of the Health Belief Model (HBM). A survey study involving 250 smokers and ex-smokers was conducted to test the conceptual model using PLS-Path modeling to validate the research hypotheses. The data were analyzed using the SPSS 27 and SmartPLS 3.3 programs. Results The results suggest that the perceived benefits of heated tobacco consumption negatively influence the likelihood of quitting smoking. Therefore, HTPs do not work as auxiliary products with regard to the intention to quit smoking. In some cases, the effect is quite the opposite, as HTPs use increases tobacco consumption and dependence. Perceived susceptibility and perceived severity are not significant predictors of the decision to quit smoking. Research limitations Future research could use a sample that includes only HTPs smokers and ex-smokers, analyze HTPs benefits and understand the primary motivation behind replacing conventional cigarettes with HTPs. Practical implications Entities attempting to promote the reduction of tobacco consumption should equate HTPs to conventional tobacco and focus on campaigns targeting only HTPs smokers. Whenever studying perceptions on HTPs, it is important to consider smokers’ dependence on nicotine and the particularities of the devices used to consume HTPs. Importance to the Social Marketing Field Considering the social relevance and growth of heated tobacco consumption, as well as the increase of the tobacco industry’s economic power, this research offers relevant insights into consumers’ perceptions toward HTPs.

Portrayal of electronic cigarettes in the news

Portrayal of electronic cigarettes in the news

Vaping and socioeconomic inequalities in smoking cessation and relapse: a longitudinal analysis of the UK Household Longitudinal Study

BackgroundSmoking is a key cause of socioeconomic health inequalities. Vaping is considered less harmful than smoking and has become a popular smoking cessation aid, and therefore has potential to reduce...

Synthesis and biological evaluation of coumarin derivatives as selective CYP2A6 inhibitors

Cytochrome P450 2A6 (CYP2A6) inhibitors are expected to be suitable as smoking cessation aids and for cancer prevention. Because the typical coumarin-based CYP2A6 inhibitor methoxsalen also inhibits CYP3A4, unintended drug-drug interactions are still a concern. Therefore, the development of selective CYP2A6 inhibitors is desirable. In this study, we synthesized coumarin-based molecules, determined the IC50 values for CYP2A6 inhibition, verified the possibility of mechanism-based inhibition, and compared the selectivity for CYP2A6 versus CYP3A4. The results demonstrated that we developed CYP2A6 inhibitors that were more potent and selective than methoxsalen.

Characterization of the Stereoselective Disposition of Bupropion and Its Metabolites in Rat Plasma and Brain.

Bupropion is an atypical antidepressant and smoking cessation aid; its use is associated with wide intersubject variability in efficacy and safety. Knowledge of the brain pharmacokinetics of bupropion and its pharmacologically active metabolites is considered important for understanding the cause-effect relationships driving this variability. Brain concentrations from rats administered a 10 mg/kg subcutaneous dose of racemic bupropion were analyzed using a stereoselective LC/MS-MS method. A 2 mg/kg dose of (S,S)-hydroxybupropion, which has comparable pharmacologic potency to bupropion, was administered to a separate group of rats. Plasma exposure and unbound concentrations in both matrices from companion equilibrium dialysis experiments were determined to assess potential carrier-mediated transport at the blood-brain barrier. Exposures to unbound forms of bupropion enantiomers were similar in plasma; this was also true in brain. This trend held for reductive diastereomer metabolite pairs in the two matrices. Unbound (R,R)-hydroxybupropion exposure was 1.5-fold higher than (S,S)-hydroxybupropion exposure in plasma and brain following bupropion administration. Unbound concentration ratios (Kp,uu) of a given molecular form decreased over time: between 4 and 6 h, these were < 1 for the two bupropion enantiomers, and they were ~ 1 for metabolites that formed. Administration of preformed (S,S)-hydroxybupropion also demonstrated a declining Kp,uu. The temporal shift in Kp,uu among the different molecular forms provides evidence regarding the operation of carrier-mediated transport and/or within-brain metabolism of bupropion, and, thereby, fresh insight regarding the causes of intersubject variability in the safety and efficacy of bupropion therapy.

Association of racial discrimination in health care settings and use of electronic cigarettes to quit smoking among Black adults

IntroductionBlack people are disproportionately burdened by tobacco-related diseases and are less successful at cigarette cessation with current treatments. We know little about the effectiveness of e-cigarettes as a smoking cessation method compared to currently approved methods in Black adults who smoke. Many Black adults report experiencing racial discrimination in health care, but if discrimination is related to utilization of smoking cessation aids including e-cigarettes and success with smoking cessation in this population is unclear. Therefore, this exploratory study aimed to understand how negative experiences and racial discrimination in health care influence use of e-cigarettes for cigarette cessation and success with cigarette cessation among Black adults. MethodsThe study interviewed 201 Black adults who used cigarettes and tried to quit in their lifetime from the Family and Community Health Study in 2016. The study asked if they had tried and successfully quit cigarettes with e-cigarettes vs. other methods (support groups, medications, nicotine replacement therapies, call-in help lines, cold turkey [quit on their own], counseling) and asked about their negative experiences and racial discrimination in health care. We performed separate logistic regressions that evaluated the association of negative experiences and racial discrimination in health care with 1) use of e-cigarettes for cigarette cessation vs. other quitting methods and 2) success with cigarette cessation using any method among Black adults while controlling for age, sex, socioeconomic status, health insurance status, and age of onset of cigarette use. ResultsMore reported negative experiences and racial discrimination in health care were associated with ever trying to quit with e-cigarettes compared to other methods (OR:1.75, 95 % CI [1.05–2.91]), but negative experiences and racial discrimination in health care were not associated with cigarette quitting success. Interestingly, trying e-cigarettes was associated with being less successful at quitting compared to using other methods to quit smoking (OR: 0.40, 95 % CI [0.20, 0.81]). ConclusionsThese results suggest that educating health care professionals that anticipated discrimination in health care settings may be driving Black adults who smoke to engage in non-evidence-based smoking cessation practices, such as e-cigarettes instead of those that are evidence-based, and may be more effective in this population.

What drives public perceptions of e-cigarettes? A mixed-methods study exploring reasons behind adults’ perceptions of e-cigarettes in Northern England

BackgroundDespite growing evidence that e-cigarettes are likely less harmful than cigarettes, perceptions of equal or more harm have increased worldwide. This study aimed to identify the most common reasons behind adults’ perceptions of the (i) relative harm of e-cigarettes compared with cigarettes and (ii) effectiveness of e-cigarettes for smoking cessation. MethodsAdults (N = 1646) from Northern England were recruited through online panels from December-March 2017/2018, using quota sampling to guarantee socio-demographic representativeness. Qualitative content analysis of open-ended responses was performed with codes representing reasons for a given perception about e-cigarettes. Percentages of participants who gave each reason for each perception were calculated. Results823 (49.9%) participants agreed that e-cigarettes were less harmful than cigarettes, 283 (17.1%) disagreed, and 540 (32.8%) were undecided. The most common reasons for agreeing that e-cigarettes were less harmful than cigarettes were that they produce no smoke (29.8%) and fewer toxins (28.9%). Those who disagreed were most concerned about a perceived lack of trustworthy research (23.7%) and safety issues (20.8%). Lacking knowledge (50.4%) was the most common reason for being undecided. 815 (49.5%) of participants agreed that e-cigarettes were an effective smoking cessation aid, 216 (13.2%) disagreed, and 615 (37.4%) were undecided. The most common reasons participants gave for agreeing were related to e-cigarettes being successful smoking replacements (50.3%) and advice from family, friends or health professionals (20.0%). Respondents who disagreed were most concerned about e-cigarettes being addictive (34.3%) and containing nicotine (15.3%). Lacking knowledge (45.2%) was the most common reason for being undecided. ConclusionsNegative perceptions of e-cigarette harm were driven by concerns about a perceived lack of research and safety issues. Adults who viewed e-cigarettes as ineffective for smoking cessation feared that they perpetuate nicotine addiction. Campaigns and guidelines that address these concerns may help promote informed perceptions.

Reducing attractiveness of e-liquids: proposal for a restrictive list of tobacco-related flavourings

ObjectiveElectronic cigarettes are addictive and harmful, and flavour is a key factor determining their abuse liability. Both adult smokers and young non-smokers like sweet and fruity flavours in particular. In...

Efficacy of digital therapeutics in smoking cessation: A systematic review and meta-analysis

Intervention based on “digital therapeutics” (DTs) to aid smoking cessation (SC) has developed in recent years. This systematic review and meta-analysis aimed to explore the efficacy of DTs in SC. Databases (PubMed, Embase, Scopus, Institute of Electrical and Electronics Engineers Xplore, ClinicalTrials, Science Direct, Web of Science, China National Knowledge Infrastructure, Chinese Science and Technology Periodical Database, Wanfang, Cochrane Central Register of Controlled Trials) from inception to June 27, 2022 were searched to collect randomized controlled trials focusing on use of DTs for SC. Revman 5.3 and Stata16 were used for meta-analysis. After literature screening, data extraction, and quality assessment by two researchers. 33 studies (19,749 participants) were included. Compared with the control group, DTs significantly increased the prevalence of abstinence of smokers [OR ​= ​1.77, 95% CI [1.39,2.26], p ​= ​0], significantly increased the point prevalence abstinence (PPA) [OR ​= ​1.45,95% CI [1.18,1.78], p ​= ​0], and improved participation in SC programs [OR ​= ​1.12,95% CI [1.01,1.24], p ​= ​0.038]. Subgroup analysis showed that, among different intervention groups, the prevalence of DTs-assisted SC in chronic obstructive pulmonary disease (COPD) smokers was higher than that in other groups [OR ​= ​5.18,95% CI [1.49,18.05], p ​= ​0.001], the prevalence of WeChat-assisted SC in smokers was higher than that in other groups [OR ​= ​4.37,95% CI [2.21,8.67], p ​= ​0]. This meta-analysis showed that DTs-assisted SC improved the prevalence of abstinence, PPA, and increased the participation of smokers in SC programs.

A Systematic Review on Effectiveness of Nicotine-Based and Non-Nicotine Based Drug Delivery System for Smoking Cessation Among the Elderly

Introduction: Smoking is associated with a higher risk of mortality, especially in smokers with cardiovascular and respiratory diseases. Smoking cessation remains the most effective approach in reducing smoking-related illness risks at all ages. For elderly smokers, smoking cessation has been proved to prolong life expectancy and reduce the risk of stroke and ischemic heart disease. However, a wide selection of smoking cessation medications makes prescribing challenging, especially among elderly smokers. Inability to recommend the best treatment may reduce the smoking cessation success rate in the elderly. Therefore, this study compares the effectiveness of pharmacotherapy available and correlate the effect of ageing on the effectiveness, leading to the recommendation of the best medication for elderly smokers. Method: A systematic searching strategy was performed in three different databases by using predetermined search strings. Results: Overall, this systematic review revealed that varenicline showed the greatest smoking cessation rate among the elderly, followed by bupropion and NRT. Conclusion: It is suggested that varenicline offered the best medical aid for smoking cessation in the elderly.