Electronic luam yeeb rau kev haus luam yeeb

Abstract

Keeb kwm

Electronic luam yeeb(ECs) yog handheld electronic vaping li uas tsim cov aerosol los ntawm cua sov e-kua.Qee cov neeg haus luam yeeb siv ECs los nres lossis txo kev haus luam yeeb, txawm hais tias qee lub koom haum, pab pawg tawm tswv yim thiab cov neeg tsim cai tau tsis txaus siab rau qhov no, hais txog qhov tsis muaj pov thawj ntawm kev ua tau zoo thiab kev nyab xeeb.Cov neeg haus luam yeeb, cov kws kho mob thiab cov tswj hwm xav paub seb ECs puas tuaj yeem pab tib neeg txiav luam yeeb, thiab yog tias lawv muaj kev nyab xeeb los siv rau lub hom phiaj no.Qhov no yog qhov kev tshuaj xyuas hloov tshiab ua ib feem ntawm kev tshuaj xyuas kev ua neej nyob.

Lub hom phiaj

Txhawm rau tshuaj xyuas qhov ua tau zoo, kev zam, thiab kev nyab xeeb ntawm kev siv cov luam yeeb hluav taws xob (ECs) los pab cov neeg haus luam yeeb kom ua tiav kev zam kev haus luam yeeb ntev.

Nrhiav txoj hauv kev

Peb tau tshawb xyuas Cochrane Tobacco Addiction Group's Specialized Register, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, thiab PsycINFO rau 1 Lub Xya Hli 2022, thiab siv-kuaj xyuas thiab hu rau cov kws sau ntawv kawm.

Cov txheej txheem xaiv

Peb suav nrog randomized controlled trials (RCTs) thiab randomized cross-over trials, uas cov neeg haus luam yeeb tau randomized rau EC lossis tswj kev mob.Peb kuj suav nrog kev tshawb fawb txog kev cuam tshuam uas tsis muaj kev tswj hwm uas txhua tus neeg koom tau txais kev cuam tshuam EC.Cov kev tshawb fawb yuav tsum tau tshaj tawm txog kev haus luam yeeb ntawm rau lub hlis lossis ntev dua lossis cov ntaub ntawv ntawm cov cim kev nyab xeeb ntawm ib lub lis piam lossis ntev dua, lossis ob qho tib si.

Kev sau thiab kev txheeb xyuas cov ntaub ntawv

Peb ua raws li cov txheej txheem Cochrane rau kev tshuaj xyuas thiab rho tawm cov ntaub ntawv.Peb qhov kev ntsuas tseem ceeb yog kev zam kev haus luam yeeb tom qab tsawg kawg rau lub hlis tom qab, cov xwm txheej tsis zoo (AEs), thiab cov xwm txheej tsis zoo (SAEs).Cov txiaj ntsig thib ob suav nrog qhov feem pua ​​​​ntawm cov neeg tseem siv cov khoom lag luam (EC lossis pharmacotherapy) ntawm rau lossis ntau lub hlis tom qab kev siv randomization lossis pib siv EC, kev hloov pauv hauv carbon monoxide (CO), ntshav siab (BP), lub plawv dhia, arterial oxygen saturation, ntsws. kev ua haujlwm, thiab qib ntawm cov carcinogens lossis toxicants, lossis ob qho tib si.Peb tau siv tus qauv Mantel-Haenszel los suav cov kev pheej hmoo sib piv (RRs) nrog rau 95% kev ntseeg siab lub sijhawm (CI) rau cov txiaj ntsig dichotomous.Rau cov txiaj ntsig tas mus li, peb suav qhov sib txawv.Yog tias tsim nyog, peb sau cov ntaub ntawv hauv meta-analyses.

Cov txiaj ntsig tseem ceeb

Peb suav nrog 78 cov kev tshawb fawb tiav, sawv cev rau 22,052 tus neeg koom, ntawm 40 yog RCTs.Kaum xya ntawm 78 suav nrog cov kev tshawb fawb tau tshiab rau qhov hloov tshiab no.Ntawm cov kev tshawb fawb suav nrog, peb tau ntsuas kaum (tag nrho tab sis ib qho ua rau peb qhov kev sib piv tseem ceeb) ntawm qhov kev pheej hmoo ntawm kev tsis ncaj ncees tag nrho, 50 muaj kev pheej hmoo siab tag nrho (suav nrog tag nrho cov kev tshawb fawb uas tsis yog-randomized), thiab qhov seem ntawm qhov pheej hmoo tsis meej.

Muaj qhov tseeb tias qhov kev txiav tawm tau siab dua hauv cov tib neeg uas tau txiav txim siab rau nicotine EC dua li ntawm cov randomized rau nicotine hloov kho (NRT) (RR 1.63, 95% CI 1.30 txog 2.04; I2 = 10%; 6 kev tshawb fawb, 2378 tus neeg koom).Hauv cov ntsiab lus tseeb, qhov no yuav txhais tau rau plaub qhov kev txiav tawm ntxiv rau 100 (95% CI 2 txog 6).Muaj cov pov thawj tsis txaus ntseeg (tso txwv los ntawm qhov tsis txaus ntseeg) tias qhov tshwm sim ntawm AEs zoo ib yam ntawm cov pab pawg (RR 1.02, 95% CI 0.88 txog 1.19; I2 = 0%; 4 kev tshawb fawb, 1702 tus neeg koom).SAEs tsis tshua muaj, tab sis tsis muaj pov thawj txaus los txiav txim seb tus nqi sib txawv ntawm cov pab pawg vim yog qhov tsis txaus ntseeg loj heev (RR 1.12, 95% CI 0.82 txog 1.52; I2 = 34%; 5 kev tshawb fawb, 2411 cov neeg koom).

Muaj cov pov thawj tsis tshua muaj tseeb, txwv los ntawm kev tsis ncaj ncees, qhov kev txiav tawm tau siab dua hauv cov tib neeg randomized rau nicotine EC dua li cov uas tsis yog-nicotine EC (RR 1.94, 95% CI 1.21 txog 3.13; I2 = 0%; 5 kev tshawb fawb, 1447 cov neeg koom). .Hauv cov ntsiab lus tseeb, qhov no yuav ua rau muaj xya tus neeg tawm tsam ntxiv rau 100 (95% CI 2 txog 16).Muaj cov pov thawj nruab nrab ntawm qhov tsis muaj qhov sib txawv ntawm tus nqi ntawm AEs ntawm cov pab pawg no (RR 1.01, 95% CI 0.91 txog 1.11; I2 = 0%; 5 kev tshawb fawb, 1840 cov neeg koom).Muaj pov thawj tsis txaus los txiav txim siab seb tus nqi ntawm SAEs txawv ntawm pawg, vim yog qhov tsis txaus ntseeg loj heev (RR 1.00, 95% CI 0.56 txog 1.79; I2 = 0%; 8 kev tshawb fawb, 1272 cov neeg koom).
Piv nrog rau kev txhawb nqa tus cwj pwm nkaus xwb / tsis muaj kev txhawb nqa, kev txiav tawm tau siab dua rau cov neeg koom nrog randomized rau nicotine EC (RR 2.66, 95% CI 1.52 txog 4.65; I2 = 0%; 7 kev tshawb fawb, 3126 tus neeg koom).Nyob rau hauv cov ntsiab lus tseeb, qhov no sawv cev rau ib qho ntxiv ob quitters rau 100 (95% CI 1 txog 3).Txawm li cas los xij, qhov kev tshawb pom no tsis tshua muaj tseeb, vim muaj teeb meem nrog kev tsis ncaj ncees thiab kev pheej hmoo ntawm kev tsis ncaj ncees.Muaj qee cov pov thawj uas (tsis mob hnyav) AEs muaj ntau dua nyob rau hauv cov neeg randomized rau nicotine EC (RR 1.22, 95% CI 1.12 txog 1.32; I2 = 41%, tsis tshua muaj tseeb; 4 kev tshawb fawb, 765 tus neeg koom) thiab, dua, tsis txaus. pov thawj los txiav txim seb tus nqi ntawm SAEs txawv ntawm pawg (RR 1.03, 95% CI 0.54 txog 1.97; I2 = 38%; 9 kev tshawb fawb, 1993 cov neeg koom).

Cov ntaub ntawv los ntawm cov kev tshawb fawb tsis-randomized tau zoo ib yam nrog RCT cov ntaub ntawv.Feem ntau tshaj tawm AEs yog caj pas / qhov ncauj khaus, mob taub hau, hnoos, thiab xeev siab, uas zoo li ploj mus nrog kev siv EC txuas ntxiv.Cov kev tshawb fawb tsawg heev tau tshaj tawm cov ntaub ntawv ntawm lwm cov txiaj ntsig lossis kev sib piv, yog li cov pov thawj rau cov no muaj tsawg, nrog CIs feem ntau suav nrog kev kho mob tseem ceeb thiab txiaj ntsig.

Cov kws sau ntawv xaus

Muaj cov pov thawj tseeb siab tias ECs nrog nicotine nce tus nqi txiav tawm piv rau NRT thiab cov pov thawj nruab nrab-tseem ceeb tias lawv nce tus nqi txiav tawm piv rau ECs yam tsis muaj nicotine.Cov ntaub ntawv pov thawj piv nicotine EC nrog kev saib xyuas ib txwm muaj / tsis muaj kev kho mob kuj qhia tau tias muaj txiaj ntsig, tab sis tsis tshua muaj tseeb.Xav tau kev tshawb fawb ntxiv kom paub meej tias qhov cuam tshuam loj.Kev ntseeg siab yog rau feem ntau ntawm cov ntaub ntawv ntawm AEs, SAEs thiab lwm yam cim kev nyab xeeb, tsis muaj qhov sib txawv ntawm AEs ntawm nicotine thiab non-nicotine ECs lossis ntawm nicotine ECs thiab NRT.Zuag qhia tag nrho cov xwm txheej ntawm SAEs yog tsawg thoob plaws txhua qhov kev kawm caj npab.Peb tsis tau pom cov pov thawj ntawm kev puas tsuaj loj los ntawm nicotine EC, tab sis qhov kev soj ntsuam ntev tshaj plaws yog ob xyoos thiab cov kev tshawb fawb tsawg.

Qhov kev txwv tseem ceeb ntawm cov pov thawj hauv paus tseem tsis muaj tseeb vim muaj tsawg tus RCTs, feem ntau nrog cov xwm txheej tsawg, tab sis ntxiv RCTs tab tom ua.Txhawm rau kom ntseeg tau tias qhov kev tshuaj xyuas txuas ntxiv muab cov ntaub ntawv tshiab rau cov neeg txiav txim siab, qhov kev tshuaj xyuas no yog kev tshuaj xyuas ua neej nyob.Peb khiav kev tshawb nrhiav txhua hli, nrog rau kev tshuaj xyuas hloov tshiab thaum muaj pov thawj tshiab muaj.Thov xa mus rau Cochrane Database of Systematic Reviews rau qhov kev tshuaj xyuas tam sim no.

Cov ntsiab lus yooj yim

Cov luam yeeb hluav taws xob puas tuaj yeem pab tib neeg kom tsis txhob haus luam yeeb, thiab lawv puas muaj qhov tsis xav tau thaum siv rau lub hom phiaj no?

Cov luam yeeb hluav taws xob yog dab tsi?

Cov luam yeeb hauv hluav taws xob (e-luam yeeb) yog cov khoom siv tes ua haujlwm los ntawm cua sov cov kua uas feem ntau muaj nicotine thiab flavorings.E-luam yeeb tso cai rau koj nqus nicotine hauv vapor es tsis haus luam yeeb.Vim tias lawv tsis hlawv cov luam yeeb, e-luam yeeb tsis ua rau cov neeg siv tib yam tshuaj uas tuaj yeem ua rau cov kab mob hauv cov neeg haus luam yeeb.

Kev siv e-luam yeeb feem ntau hu ua 'vaping'.Ntau tus neeg siv e-luam yeeb los pab lawv kom tsis txhob haus luam yeeb.Hauv kev tshuaj xyuas no peb tsom feem ntau ntawm e-luam yeeb uas muaj nicotine.

Vim li cas peb tau ua qhov Kev Ntsuam Xyuas Cochrane

Tsis txhob haus luam yeeb txo koj txoj kev pheej hmoo ntawm mob ntsws cancer, mob plawv thiab ntau yam kab mob.Ntau tus neeg pom tias nws nyuaj kom tsis txhob haus luam yeeb.Peb xav paub seb puas siv e-luam yeeb tuaj yeem pab tib neeg kom tsis txhob haus luam yeeb, thiab yog tias tib neeg siv lawv rau lub hom phiaj no muaj kev cuam tshuam tsis zoo.

Peb ua dab tsi?

Peb tau tshawb nrhiav cov kev tshawb fawb uas saib kev siv e-luam yeeb los pab tib neeg kom tsis txhob haus luam yeeb.

Peb tau saib rau qhov kev sim ntsuas randomized, uas cov kev kho mob uas tib neeg tau txais tau txiav txim siab ntawm random.Hom kev kawm no feem ntau muab cov pov thawj ntseeg siab tshaj plaws txog cov teebmeem ntawm kev kho mob.Peb kuj tau nrhiav kev tshawb fawb uas txhua tus tau txais kev kho mob e-luam yeeb.

Peb txaus siab nrhiav kom paub:

· Muaj pes tsawg tus neeg tsis haus luam yeeb tsawg kawg rau lub hlis;thiab
· Muaj pes tsawg tus neeg muaj qhov tsis xav tau, tshaj tawm tom qab siv tsawg kawg ib lub lis piam.

Nrhiav hnub: Peb suav nrog cov pov thawj tshaj tawm txog 1st Lub Xya Hli 2022.

Peb pom dab tsi

Peb pom 78 cov kev tshawb fawb uas suav nrog 22,052 cov neeg laus uas haus luam yeeb.Cov kev tshawb fawb piv e-luam yeeb nrog:

· nicotine hloov kho, xws li thaj tsam lossis cov pos hniav;

· varenicline (ib yam tshuaj pab tib neeg kom tsis txhob haus luam yeeb);
· e-luam yeeb yam tsis muaj nicotine;

· Lwm hom nicotine-muaj e-luam yeeb (xws li cov khoom siv hauv pods, cov khoom siv tshiab dua);
· kev txhawb nqa tus cwj pwm, xws li kev qhia lossis kev sab laj;los yog
· tsis muaj kev txhawb nqa rau kev txiav luam yeeb.

Feem ntau cov kev tshawb fawb tau tshwm sim hauv Asmeskas (34 kev tshawb fawb), UK (16), thiab Ltalis (8).

Cov txiaj ntsig ntawm peb qhov kev tshuaj xyuas yog dab tsi?

Cov neeg feem ntau yuav tsum tsis txhob haus luam yeeb tsawg kawg rau lub hlis uas siv nicotine e-luam yeeb dua li kev siv cov tshuaj hloov nicotine (6 kev tshawb fawb, 2378 tus neeg), lossis e-luam yeeb yam tsis muaj nicotine (5 kev tshawb fawb, 1447 tus neeg).

Nicotine e-luam yeeb yuav pab tau ntau tus neeg kom tsis txhob haus luam yeeb dua li tsis muaj kev txhawb nqa lossis kev coj tus cwj pwm nkaus xwb (7 kev tshawb fawb, 3126 tus neeg).

Rau txhua 100 tus neeg siv cov nicotine e-luam yeeb kom tsis txhob haus luam yeeb, 9 txog 14 yuav tsum tau ua tiav, piv nrog tsuas yog 6 ntawm 100 tus neeg siv cov tshuaj nicotine hloov pauv, 7 ntawm 100 siv e-luam yeeb yam tsis muaj nicotine, lossis 4 ntawm 100 tus neeg tsis muaj kev txhawb nqa lossis kev coj cwj pwm nkaus xwb.

Peb tsis paub meej yog tias muaj qhov sib txawv ntawm qhov tsis xav tau tshwm sim los ntawm kev siv nicotine e-luam yeeb piv nrog nicotine hloov kho, tsis muaj kev txhawb nqa lossis kev txhawb nqa tus cwj pwm nkaus xwb.Muaj qee cov pov thawj uas tsis muaj qhov tsis xav tau tshwm sim ntau dua hauv cov pab pawg tau txais nicotine e-luam yeeb piv rau tsis muaj kev txhawb nqa lossis kev txhawb nqa tus cwj pwm nkaus xwb.Tsawg tus lej ntawm cov teebmeem tsis xav tau, suav nrog cov teebmeem tsis xav tau loj, tau tshaj tawm hauv cov kev tshawb fawb piv rau nicotine e-luam yeeb rau nicotine hloov kho.Tej zaum tsis muaj qhov sib txawv ntawm qhov muaj pes tsawg leeg tsis xav tau tshwm sim hauv cov neeg siv cov nicotine e-luam yeeb piv rau e-luam yeeb yam tsis muaj nicotine.

Cov teebmeem tsis xav tau tshaj tawm feem ntau nrog nicotine e-luam yeeb yog caj pas lossis qhov ncauj khaus, mob taub hau, hnoos thiab mob.Cov teebmeem no tau txo qis dhau sijhawm thaum tib neeg txuas ntxiv siv nicotine e-luam yeeb.

Cov txiaj ntsig no ntseeg tau li cas?

Peb cov txiaj ntsig yog nyob ntawm ob peb txoj kev tshawb fawb rau feem ntau cov txiaj ntsig, thiab rau qee qhov txiaj ntsig, cov ntaub ntawv sib txawv.

Peb pom cov pov thawj tias nicotine e-luam yeeb pab ntau tus neeg kom tsis txhob haus luam yeeb dua li nicotine hloov kho.Nicotine e-luam yeeb tej zaum yuav pab tau ntau tus neeg kom tsis txhob haus luam yeeb dua li e-luam yeeb yam tsis muaj nicotine tab sis tseem xav tau kev tshawb fawb ntxiv kom paub meej qhov no.

Cov kev tshawb fawb sib piv cov nicotine e-luam yeeb nrog kev coj cwj pwm lossis tsis muaj kev txhawb nqa kuj pom tias muaj kev txiav tawm ntau dua rau cov neeg siv cov nicotine e-luam yeeb, tab sis muab cov ntaub ntawv tsawg dua vim muaj teeb meem nrog kev kawm tsim.

Feem ntau ntawm peb cov txiaj ntsig rau qhov tsis xav tau tuaj yeem hloov pauv thaum muaj pov thawj ntxiv.

Cov lus tseem ceeb

Nicotine e-luam yeeb tuaj yeem pab tib neeg kom tsis txhob haus luam yeeb tsawg kawg rau lub hlis.Cov ntaub ntawv pov thawj pom tias lawv ua haujlwm zoo dua li nicotine hloov kho, thiab tej zaum zoo dua li e-luam yeeb yam tsis muaj nicotine.

Tej zaum lawv yuav ua haujlwm zoo dua li tsis muaj kev txhawb nqa, lossis kev txhawb nqa tus cwj pwm ib leeg, thiab lawv yuav tsis cuam tshuam nrog kev cuam tshuam loj heev.

Txawm li cas los xij, peb tseem xav tau cov ntaub ntawv pov thawj ntxiv, tshwj xeeb tshaj yog hais txog qhov cuam tshuam ntawm hom tshiab ntawm e-luam yeeb uas muaj nicotine xa zoo dua li cov laus hom e-luam yeeb, vim tias kev xa khoom nicotine zoo dua tuaj yeem pab ntau tus neeg txiav luam yeeb.