1
|
Chaiton MO, Seth S, Dubray J, Schwartz R. NRT use as a vaping cessation aid among youth and young adults. Tob Control 2024:tc-2024-058823. [PMID: 39304192 DOI: 10.1136/tc-2024-058823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2024] [Accepted: 09/06/2024] [Indexed: 09/22/2024]
Affiliation(s)
- Michael O Chaiton
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Ontario Tobacco Research Unit, University of Toronto, Toronto, Ontario, Canada
| | - Siddharth Seth
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Queen's University, Kingston, Ontario, Canada
| | - Jolene Dubray
- Ontario Tobacco Research Unit, University of Toronto, Toronto, Ontario, Canada
| | - Robert Schwartz
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Ontario Tobacco Research Unit, University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
2
|
Hannah M, Fadel MP, Tulloch T. E-cigarette use in adolescents. CMAJ 2024; 196:E445. [PMID: 38589024 PMCID: PMC11001387 DOI: 10.1503/cmaj.230925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/10/2024] Open
Affiliation(s)
- Madelynn Hannah
- Department of Pharmacy (Hannah), Hospital for Sick Children; Leslie Dan Faculty of Pharmacy (Hannah), University of Toronto; Department of Psychiatry (Fadel), Hospital for Sick Children; Division of Child and Youth Mental Health (Fadel), Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto; Division of Adolescent Medicine (Tulloch), Hospital for Sick Children; Nicotine Dependence Clinic (Tulloch), Centre for Addiction and Mental Health, Toronto, Ont
| | - Marc P Fadel
- Department of Pharmacy (Hannah), Hospital for Sick Children; Leslie Dan Faculty of Pharmacy (Hannah), University of Toronto; Department of Psychiatry (Fadel), Hospital for Sick Children; Division of Child and Youth Mental Health (Fadel), Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto; Division of Adolescent Medicine (Tulloch), Hospital for Sick Children; Nicotine Dependence Clinic (Tulloch), Centre for Addiction and Mental Health, Toronto, Ont
| | - Trisha Tulloch
- Department of Pharmacy (Hannah), Hospital for Sick Children; Leslie Dan Faculty of Pharmacy (Hannah), University of Toronto; Department of Psychiatry (Fadel), Hospital for Sick Children; Division of Child and Youth Mental Health (Fadel), Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto; Division of Adolescent Medicine (Tulloch), Hospital for Sick Children; Nicotine Dependence Clinic (Tulloch), Centre for Addiction and Mental Health, Toronto, Ont.
| |
Collapse
|
3
|
McKay F, Chan L, Cerio R, Rickards S, Hastings P, Reakes K, O'Brien T, Dunn M. Assessing the Quality and Behavior Change Potential of Vaping Cessation Apps: Systematic Search and Assessment. JMIR Mhealth Uhealth 2024; 12:e55177. [PMID: 38532616 PMCID: PMC11004626 DOI: 10.2196/55177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 02/14/2024] [Accepted: 02/20/2024] [Indexed: 03/28/2024] Open
Abstract
Background An increasing number of people are using vapes (e-cigarettes), and with growing evidence of associated harms, there is a need for acceptable cessation support and interventions. Smartphone apps for health and well-being have increased in popularity and use. Limited published literature assesses the potential of apps to support vaping cessation. Objective A systematic search of vaping cessation apps currently available in Australia for iOS and Android platforms was conducted. Apps were assessed against established health app assessment tools for quality and behavior change potential. Methods A systematic search through the Australian Apple iTunes and Google Play stores was conducted using the search terms "vape"; "vaping"; "e-cigarette"; and "cessation," "quit," or "quitting" in May 2023. Only apps that encouraged the cessation of vaping were included. App descriptions were reviewed to determine if they were relevant for inclusion in this study, and relevant apps were downloaded onto the appropriate mobile device for review. The Mobile App Rating Scale (MARS) was used to rate the quality (engagement, functionality, aesthetics, and information) of the apps using an overall score out of 5. The App Behavior Change Scale (ABACUS) was used to assess the behavior change potential of each app using a score out of 21. Results An initial search of the app stores yielded 220 Android apps and 124 iOS apps. Screening against the inclusion criteria left 20 iOS apps and 10 Android apps for review. Six apps were available on both operating systems, and these were downloaded, reviewed, and reported separately for each operating system. The average MARS score for all apps assessed in this review was 3.1 (SD 0.41) out of 5. The reviewed apps overall performed well for the MARS elements relating to functionality, such as ease of use and navigation, but had the lowest scores for information-related elements, such as credibility. The number of ABACUS behavior change features per app ranged from 0 to 19 out of 21, with a mean of 8.9 (SD 4.51). The apps commonly included information-related features, such as requesting baseline information. The least common behavior change features were those relating to goal-setting, such as asking about the user's willingness for behavior change and providing feedback on current actions in comparison to future goals. Conclusions The identified vaping cessation apps had moderate levels of quality and some behavior change components. Future vaping cessation apps could benefit from including more features that are known to support behavior change, such as goal-setting, to improve the potential benefit of these apps to support people to stop vaping. As guidelines for vaping cessation continue to be established, future apps need to reference these in their development.
Collapse
Affiliation(s)
- Fiona McKay
- Instutite for Health Transformation, Faculty of Health, Deakin University, Geelong, Victoria, Australia
- The School of Health and Social Development, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Lilian Chan
- Cancer Institute of New South Wales, St. Leonards, New South Wales, Australia
| | - Rebecca Cerio
- Cancer Institute of New South Wales, St. Leonards, New South Wales, Australia
| | - Sandra Rickards
- Cancer Institute of New South Wales, St. Leonards, New South Wales, Australia
| | - Phillipa Hastings
- Cancer Institute of New South Wales, St. Leonards, New South Wales, Australia
| | - Kate Reakes
- Cancer Institute of New South Wales, St. Leonards, New South Wales, Australia
| | - Tracey O'Brien
- Cancer Institute of New South Wales, St. Leonards, New South Wales, Australia
| | - Matthew Dunn
- Instutite for Health Transformation, Faculty of Health, Deakin University, Geelong, Victoria, Australia
- The School of Health and Social Development, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| |
Collapse
|
4
|
Caponnetto P, Spicuzza L, Campagna D, Ahluwalia JS, Russell C, Maglia M, Riela PM, Longo CF, Caci G, Quattropani MC, Signorelli MS, Polosa R. Varenicline for smoking cessation in individuals who smoke cigarettes and use electronic cigarettes: a double-blind, randomised, placebo-controlled phase 3 trial. EClinicalMedicine 2023; 66:102316. [PMID: 38192585 PMCID: PMC10772233 DOI: 10.1016/j.eclinm.2023.102316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 10/24/2023] [Accepted: 10/30/2023] [Indexed: 01/10/2024] Open
Abstract
Background The efficacy and safety of varenicline for smoking cessation among individuals who smoke tobacco cigarettes and also use electronic cigarettes (known e-cigarettes or vapes) have not been studied. We aimed to address this knowledge gap and examine predictors for smoking abstinence. Methods In this double-blind, placebo-controlled, single-centre randomised trial in Italy, we enrolled adults who had used an e-cigarette daily for at least 12 months and who also smoked at least one tobacco cigarette per day and had a willingness to quit smoking. 155 participants were randomly assigned to receive either varenicline (n = 78) or matched placebo (n = 77). Varenicline (1 mg, administered twice daily for 12 weeks) was given in combination with smoking cessation counseling in dual users with an intention to quit smoking. Participants in both treatment groups received the same smoking cessation counselling throughout the whole duration of the study. The trial consisted of a 12-week treatment phase followed by a 12-week follow-up. The primary efficacy endpoint was continuous abstinence rate (CAR) in weeks 4-12. Secondary efficacy endpoints were the CAR in weeks 4-24 and 7-day point prevalence of smoking abstinence at weeks 12 and 24. This study is registered in EUDRACT, 2016-000339-42. Findings Between November 2018, and February 2020, 114 participants (61 in the varenicline group and 53 in the placebo group) completed the intervention phase at week 12 and 88 participants (52 in the varenicline group and 36 in the placebo group) completed the follow-up phase at week 24. CARs were significantly higher for the varenicline vs placebo at each time-point: 50.0% vs 16.9% (OR = 4.9; 95% CI, 2.3-10.4; P < 0.0001) between weeks 4 and 12; and 48.7% vs 14.3% (OR = 5.7; 95% CI, 2.6-12.3; P < 0.0001) between weeks 4 and 24. The 7-day point prevalence of smoking abstinence was also higher for the varenicline than placebo at each time point. Adverse events were rated as mild or moderate and rarely led to treatment discontinuation. Interpretation Our findings indicate that inclusion of varenicline in a cessation programme for adults who smoke and use e-cigarettes with an intention to quit smoking could result in smoking abstinence without serious adverse events. In the absence of evidence from other smoking cessation methods, it could be useful to suggest the use of varenicline in cessation programmes specifically designed to help dual users stop smoking. Further research in larger and more generalisable populations is required to strengthen such a suggestion. Funding Global Research Award for Nicotine Dependence, an independently reviewed competitive grants programmeme funded by Pfizer.
Collapse
Affiliation(s)
- Pasquale Caponnetto
- Department of Science of Education, Section of Psychology, University of Catania, Italy
- Centre of Excellence for the Acceleration of HArm Reduction (CoEHAR), University of Catania, Italy
- Centre for the Prevention and Treatment of Tobacco Addiction (CPCT), University Teaching Hospital “Policlinico-S.Marco”, University of Catania, Italy
| | - Lucia Spicuzza
- Centre of Excellence for the Acceleration of HArm Reduction (CoEHAR), University of Catania, Italy
- Respiratory Unit - University Teaching Hospital “Policlinico-S.Marco”, University of Catania, Italy
- Department of Clinical & Experimental Medicine, University of Catania, Italy
| | - Davide Campagna
- Centre of Excellence for the Acceleration of HArm Reduction (CoEHAR), University of Catania, Italy
- Department of Clinical & Experimental Medicine, University of Catania, Italy
- UOC MCAU, University Teaching Hospital “Policlinico-S.Marco”, University of Catania, Italy
| | - Jasjit S. Ahluwalia
- Brown University School of Public Health and Alpert School of Medicine, Providence, RI, USA
| | | | - Marilena Maglia
- Centre for the Prevention and Treatment of Tobacco Addiction (CPCT), University Teaching Hospital “Policlinico-S.Marco”, University of Catania, Italy
- ECLAT Srl, Spin-off of the University of Catania, Italy
| | - Paolo Marco Riela
- Department of Mathematics and Informatics, University of Catania, Catania, Italy
| | - Carmelo Fabio Longo
- Department of Mathematics and Informatics, University of Catania, Catania, Italy
| | - Grazia Caci
- UOC MCAU, University Teaching Hospital “Policlinico-S.Marco”, University of Catania, Italy
| | - Maria Catena Quattropani
- Department of Science of Education, Section of Psychology, University of Catania, Italy
- Centre of Excellence for the Acceleration of HArm Reduction (CoEHAR), University of Catania, Italy
| | | | - Riccardo Polosa
- Centre of Excellence for the Acceleration of HArm Reduction (CoEHAR), University of Catania, Italy
- Centre for the Prevention and Treatment of Tobacco Addiction (CPCT), University Teaching Hospital “Policlinico-S.Marco”, University of Catania, Italy
- Department of Clinical & Experimental Medicine, University of Catania, Italy
| |
Collapse
|
5
|
Zawertailo L, Kouzoukas E, Fougere C, Dragonetti R, Veldhuizen S, Selby P. Clinical guidance for e-cigarette (vaping) cessation: Results from a modified Delphi panel approach. Prev Med Rep 2023; 35:102372. [PMID: 37654515 PMCID: PMC10466900 DOI: 10.1016/j.pmedr.2023.102372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 08/11/2023] [Accepted: 08/15/2023] [Indexed: 09/02/2023] Open
Abstract
Individuals seek help to stop their use of e-cigarettes from their healthcare practitioners. However, there is a paucity of published work addressing e-cigarette cessation methods empirically, and what evidence that is available is weak. Therefore, we developed an expert informed clinical resource to guide practitioners helping their clients quit using e-cigarettes. We conducted a modified Delphi process between September and December 2021 to reach consensus on clinical recommendations for e-cigarette cessation. Expert and Peer Panel members (n = 28) voted and provided feedback on the recommendations through three rounds of structured surveys, a discussion board, and one intermediate survey. The penultimate knowledge products underwent usability testing and were finalized based on user feedback. The Expert Panel maintained a 100% response rate for rounds 1 and 2 and 96% for round 3; the Peer Panel achieved a 100% response rate for all three rounds of the modified Delphi process. Consensus was reach on 24 recommendations and 2 statements spanning eight domains: severity and dependence; general approaches; treatment approaches; dual use; pharmacotherapy strategies; behavioural therapy strategies; harm reduction; and relapse prevention. Two additional 'no agreement' statements that did not reach consensus are included in the guidance resource. The recommendations were also contextualized for the following groups: adults; youth; people who are pregnant, breastfeeding and/or chestfeeding; and people with mental illness and/or substance use issues. The recommendations listed in the resource provide general clinical guidance on e-cigarette cessation to assist healthcare practitioners in the treatment planning process.
Collapse
Affiliation(s)
- Laurie Zawertailo
- Nicotine Dependence Service, Addictions Program, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
| | - Erika Kouzoukas
- Nicotine Dependence Service, Addictions Program, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Chantal Fougere
- Nicotine Dependence Service, Addictions Program, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Rosa Dragonetti
- Nicotine Dependence Service, Addictions Program, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | - Scott Veldhuizen
- Nicotine Dependence Service, Addictions Program, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Peter Selby
- Nicotine Dependence Service, Addictions Program, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| |
Collapse
|
6
|
Klein J, Diaba-Nuhoho P, Giebe S, Brunssen C, Morawietz H. Regulation of endothelial function by cigarette smoke and next-generation tobacco and nicotine products. Pflugers Arch 2023:10.1007/s00424-023-02824-w. [PMID: 37285061 DOI: 10.1007/s00424-023-02824-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 05/26/2023] [Accepted: 05/26/2023] [Indexed: 06/08/2023]
Abstract
Cigarette smoking is the most important avoidable cardiovascular risk factor. It causes endothelial dysfunction and atherosclerosis and increases the risk of its severe clinical complications like coronary artery disease, myocardial infarction, stroke, and peripheral artery disease. Several next-generation tobacco and nicotine products have been developed to decrease some of the deleterious effects of regular tobacco smoking. This review article summarizes recent findings about the impact of cigarette smoking and next-generation tobacco and nicotine products on endothelial dysfunction. Both cigarette smoking and next-generation tobacco products lead to impaired endothelial function. Molecular mechanisms of endothelial dysfunction like oxidative stress, reduced nitric oxide availability, inflammation, increased monocyte adhesion, and cytotoxic effects of cigarette smoke and next-generation tobacco and nicotine products are highlighted. The potential impact of short- and long-term exposure to next-generation tobacco and nicotine products on the development of endothelial dysfunction and its clinical implications for cardiovascular diseases are discussed.
Collapse
Affiliation(s)
- Justus Klein
- Department of Medicine III, Division of Vascular Endothelium and Microcirculation, Faculty of Medicine, University Hospital Carl Gustav Carus Dresden, TUD Dresden University of Technology, Fetscherstr. 74, D-01307, Dresden, Germany
| | - Patrick Diaba-Nuhoho
- Department of Medicine III, Division of Vascular Endothelium and Microcirculation, Faculty of Medicine, University Hospital Carl Gustav Carus Dresden, TUD Dresden University of Technology, Fetscherstr. 74, D-01307, Dresden, Germany
- Department of Paediatric and Adolescent Medicine, Paediatric Haematology and Oncology, University Hospital Münster, Albert-Schweitzer-Str. 33, D-48149, Münster, Germany
| | - Sindy Giebe
- Department of Medicine III, Division of Vascular Endothelium and Microcirculation, Faculty of Medicine, University Hospital Carl Gustav Carus Dresden, TUD Dresden University of Technology, Fetscherstr. 74, D-01307, Dresden, Germany
| | - Coy Brunssen
- Department of Medicine III, Division of Vascular Endothelium and Microcirculation, Faculty of Medicine, University Hospital Carl Gustav Carus Dresden, TUD Dresden University of Technology, Fetscherstr. 74, D-01307, Dresden, Germany
| | - Henning Morawietz
- Department of Medicine III, Division of Vascular Endothelium and Microcirculation, Faculty of Medicine, University Hospital Carl Gustav Carus Dresden, TUD Dresden University of Technology, Fetscherstr. 74, D-01307, Dresden, Germany.
| |
Collapse
|