Abstract
Imvelaphi
Imidiza ye-elektroniki(ii-ECs) zizixhobo zomphunga zombane eziphathwa ngesandla ezivelisa i-aerosol ngokufudumeza i-e-liquid.Abanye abantu abatshayayo basebenzisa ii-ECs ukuba bayeke okanye banciphise ukutshaya, nangona eminye imibutho, amaqela akhuthazayo kunye nabaqulunqi bemigaqo-nkqubo baye badikibala oku, bekhankanya ukungabikho kobungqina bokusebenza kunye nokhuseleko.Abantu abatshayayo, ababoneleli bezempilo kunye nabalawuli bafuna ukwazi ukuba ii-ECs zinokunceda abantu bayeke ukutshaya, kwaye ukuba bakhuselekile ukusebenzisa le njongo.Olu luhlaziyo lophononongo olwenziwe njengenxalenye yophononongo oluphilayo lwenkqubo.
Iinjongo
Ukuphonononga ukusebenza, ukunyamezela, kunye nokhuseleko lokusebenzisa icuba ze-elektroniki (ECs) ukunceda abantu abatshaya icuba ukuba bafikelele ixesha elide lokuyeka ukutshaya.
Iindlela zokukhangela
Siphendle iRejista yeQela eliKhethekileyo leCochrane yeTobacco Addiction, iRejista yeCochrane Central yeZilingo eziLawulwayo (CENTRAL), MEDLINE, Embase, kunye ne-PsycINFO ukuya kwi-1 kaJulayi 2022, kunye nereferensi-yajongwa kwaye yaqhagamshelwa nababhali bokufunda.
Iikhrayitheriya zokukhetha
Sifake izilingo ezilawulwa ngokungenamkhethe (RCTs) kunye nezilingo ezinqamlezayo, apho abantu abatshayayo bahlelwe ngokungaqhelekanga kwi-EC okanye kwimeko yokulawula.Siphinde sabandakanya izifundo zokungenelela ezingalawulwayo apho bonke abathathi-nxaxheba bafumana ukungenelela kwe-EC.Uphononongo kwafuneka luchaze ukuyeka ukutshaya kwiinyanga ezintandathu okanye ngaphezulu okanye idatha kwiimpawu zokhuseleko ngeveki enye okanye ngaphezulu, okanye zombini.
Ukuqokelelwa kwedatha kunye nohlalutyo
Silandele iindlela eziqhelekileyo zeCochrane zokuhlola kunye nokutsalwa kwedatha.Iziphumo zethu eziphambili zeziphumo yayikukuyeka ukutshaya emva kokulandela ubuncinci iinyanga ezintandathu, iziganeko ezimbi (AEs), kunye neziganeko ezimbi kakhulu (SAEs).Iziphumo zeSekondari zibandakanya umlinganiselo wabantu abasasebenzisa imveliso yokufunda (EC okanye i-pharmacotherapy) kwiinyanga ezintandathu okanye ngaphezulu emva kwe-randomization okanye ukuqala ukusetyenziswa kwe-EC, utshintsho kwi-carbon monoxide (CO), uxinzelelo lwegazi (BP), izinga lentliziyo, i-arterial saturation, imiphunga. umsebenzi, kunye namanqanaba e-carcinogens okanye i-toxicants, okanye zombini.Sisebenzise imodeli ye-Mantel-Haenszel enesiphumo esisisigxina ukubala umlinganiselo womngcipheko (RRs) kunye ne-95% yexesha lokuzithemba (CI) kwiziphumo ze-dichotomous.Kwiziphumo eziqhubekayo, sibale iiyantlukwano ezithetha.Apho kufanelekileyo, sidibanise idatha kuhlalutyo lwemeta.
Iziphumo eziphambili
Sibandakanya izifundo ezigqityiweyo ze-78, ezimele abathathi-nxaxheba be-22,052, apho i-40 yayiyi-RCTs.Ishumi elinesixhenxe kwii-78 ezibandakanyiweyo izifundo bezintsha kolu hlaziyo lophononongo.Kwizifundo ezibandakanyiweyo, silinganise ishumi (zonke kodwa enye inegalelo kuthelekiso lwethu oluphambili) kumngcipheko ophantsi wokuthambekela, i-50 emngciphekweni omkhulu jikelele (kubandakanywa nazo zonke izifundo ezingahleliwe), kunye nentsalela kumngcipheko ongacacanga.
Kwakukho ukuqiniseka okuphezulu ukuba amazinga okuyeka ayephezulu kubantu abangaqhelekanga kwi-nicotine EC kunezo zingahleliwe kwi-nicotine yonyango yokutshintshwa (NRT) (RR 1.63, 95% CI 1.30 kwi-2.04; I2 = 10%; Izifundo ze-6, abathathi-nxaxheba be-2378).Ngokwemigaqo epheleleyo, oku kunokuguqulela kwii-quitters ezine ezongezelelweyo nge-100 (95% CI 2 ukuya kwi-6).Kwakukho ubungqina obuphakathi (ukunqunyulwa ngokungachanekanga) ukuba izinga lokwenzeka kwe-AEs lalifana phakathi kwamaqela (RR 1.02, 95% CI 0.88 ukuya ku-1.19; I2 = 0%; izifundo ze-4, abathathi-nxaxheba be-1702).Ii-SAE zazinqabile, kodwa kwakungekho ubungqina obaneleyo bokuqinisekisa ukuba amazinga ahluke phakathi kwamaqela ngenxa yokungachaneki kakhulu (RR 1.12, 95% CI 0.82 kwi-1.52; I2 = 34%; izifundo ze-5, abathathi-nxaxheba be-2411).
Kwakukho ubungqina obuqinisekileyo, obulinganiselwe ngokungachanekanga, ukuba amazinga okuyeka ayephezulu kubantu abangahlelwanga kwi-nicotine EC kune-non-nicotine EC (RR 1.94, 95% CI 1.21 ukuya ku-3.13; I2 = 0%; Izifundo ze-5, abathathi-nxaxheba be-1447) .Ngokwemigqaliselo epheleleyo, oku kunokukhokelela ekuyekeni okongezelelweyo ezisixhenxe nge-100 (95% CI 2 ukuya kwi-16).Bekukho ubungqina obuqinisekileyo bokungabikho kwantlukwano kwireyithi ye-AEs phakathi kwala maqela (RR 1.01, 95% CI 0.91 ukuya ku-1.11; I2 = 0%; izifundo ezi-5, abathathi-nxaxheba be-1840).Kwakungekho ubungqina obaneleyo bokuqinisekisa ukuba amazinga e-SAE ahluke phakathi kwamaqela, ngenxa yokungachaneki kakhulu (RR 1.00, 95% CI 0.56 kwi-1.79; I2 = 0%; izifundo ze-8, abathathi-nxaxheba be-1272).
Xa kuthelekiswa nokuxhaswa kokuziphatha kuphela / akukho nkxaso, amazinga okuyeka ayephezulu kubathathi-nxaxheba kwi-nicotine EC (RR 2.66, 95% CI 1.52 kwi-4.65; I2 = 0%; izifundo ze-7, abathathi-nxaxheba be-3126).Ngokwemigaqo ecacileyo, oku kubonisa ukushiya ezimbini ezongezelelweyo kwi-100 (95% CI 1 ukuya kwi-3).Nangona kunjalo, oku kufunyanisiweyo bekunesiqinisekiso esiphantsi kakhulu, ngenxa yemiba yokungachaneki kunye nomngcipheko wokuthatha icala.Kwakukho ubungqina bokuthi (ezingekho nzulu) ii-AEs zazixhaphake kakhulu kubantu abangaqhelekanga kwi-nicotine EC (RR 1.22, 95% CI 1.12 ukuya kwi-1.32; I2 = 41%, ukuqiniseka okuphantsi; izifundo ze-4, abathathi-nxaxheba be-765) kwaye, kwakhona, akwanelanga. ubungqina bokuqinisekisa ukuba amazinga e-SAE ahluke phakathi kwamaqela (RR 1.03, 95% CI 0.54 ukuya kwi-1.97; I2 = 38%; izifundo ze-9, abathathi-nxaxheba be-1993).
Idatha evela kwizifundo ezingakhethiswanga zazihambelana nedatha ye-RCT.Ezona zixelwa kakhulu ii-AEs ibikukurhawuzelelwa komqala/nomlomo, intloko ebuhlungu, ukukhohlela, kunye nesicaphucaphu, ezithande ukuphela ngokuqhubeka nokusetyenziswa kweEC.Izifundo ezimbalwa kakhulu zichaze idatha kwezinye iziphumo okanye uthelekiso, kungoko ubungqina bezi zinto bunqongophele, kwaye iiCI zihlala zibandakanya umonakalo omkhulu kunye nenzuzo yeklinikhi.
Izigqibo zababhali
Kukho ubungqina obuqinisekileyo bokuba ii-ECs ezine-nicotine zonyuka amazinga okuyeka xa kuthelekiswa ne-NRT kunye nobungqina obuphakathi-bubungqina bokuba bonyusa amazinga okuyeka xa kuthelekiswa nee-ECs ngaphandle kwenikotini.Ubungqina bokuthelekisa i-nicotine EC kunye nokhathalelo oluqhelekileyo/akukho nyango lukwacebisa inzuzo, kodwa ayiqinisekanga kangako.Uphononongo olongezelelweyo luyafuneka ukuqinisekisa ubungakanani besiphumo.Amaxesha okuzithemba ayelelona nqanaba libanzi ledatha kwii-AEs, ii-SAEs kunye nezinye iimpawu zokhuseleko, kungekho mahluko kwii-AEs phakathi kwe-nicotine kunye ne-non-nicotine ECs naphakathi kwe-nicotine ECs kunye ne-NRT.Lilonke izehlo zee-SAEs bezisezantsi kuzo zonke iingalo zokufunda.Asizange sifumane ubungqina bomonakalo omkhulu kwi-nicotine EC, kodwa ukulandelwa okude kakhulu kwakuyiminyaka emibini kwaye inani lezifundo lalincinci.
Umda oyintloko wesiseko sobungqina uhlala ungachanekanga ngenxa yenani elincinci le-RCTs, ngokuqhelekileyo kunye namazinga aphantsi esiganeko, kodwa ii-RCT ezongezelelweyo ziyaqhubeka.Ukuqinisekisa ukuba uphononongo luyaqhubeka nokubonelela ngolwazi oluhlaziyiweyo kubenzi bezigqibo, olu phononongo luphononongo lwenkqubo ephilayo.Siqhuba uphendlo rhoqo ngenyanga, ngophononongo oluhlaziyiweyo xa ubungqina obutsha bufumanekayo.Nceda ubhekiselele kwiDatha yeCochrane yoPhononongo oluCwangcisiweyo lwemeko yophononongo lwangoku.
Isishwankathelo solwimi olulula
Ngaba imidiza ye-elektroniki inokubanceda abantu bayeke ukutshaya, kwaye ingaba nayo nayiphi na imiphumo engathandekiyo xa isetyenziselwa le njongo?
Yintoni imidiza ye-elektroniki?
Imidiza yombane (i-e‐cigarettes) zizixhobo eziphathwa ngesandla ezisebenza ngokufudumeza ulwelo oluhlala luqulathe inikotini kunye nezinongo.I-e-cigarettes ikuvumela ukuba uphefumlele inikotini emphunga kunokuba utshaye.Ngenxa yokuba bengalitshisi icuba, i-e-cigarettes ayivezi abasebenzisi kumanqanaba afanayo eekhemikhali ezinokubangela izifo kubantu abatshaya icuba eliqhelekileyo.
Ukusebenzisa i-e-cigarette kwaziwa njenge 'vaping'.Abantu abaninzi basebenzisa i-e-cigarettes ukubanceda ukuba bayeke ukutshaya.Kolu hlaziyo sijolise ikakhulu kwi-e-cigarettes equkethe inikotini.
Kutheni senze olu hlaziyo lweCochrane
Ukuyeka ukutshaya kwehlisa umngcipheko wokuba nomhlaza wemiphunga, isifo sentliziyo kunye nezinye izifo ezininzi.Abantu abaninzi bakufumanisa kunzima ukuyeka ukutshaya.Besifuna ukufumanisa ukuba ukusebenzisa i-e‐cigarettes kunganceda na abantu ukuba bayeke ukutshaya, kwaye ukuba abantu abayisebenzisela le njongo bafumana naziphi na iziphumo ezingafunekiyo.
Senze ntoni?
Sikhangele izifundo ezijonga ukusetyenziswa kwe-e‐cigarettes ukunceda abantu bayeke ukutshaya.
Sijonge amalingo alawulwa ngokungakhethiyo, apho unyango olufunyenwe ngabantu lugqitywe ngokungakhethi.Olu hlobo lophononongo lukholisa ukunika obona bungqina buthembekileyo malunga neziphumo zonyango.Siye sajonga nezifundo apho wonke umntu wafumana unyango lwe-e‐cuba.
Besinomdla wokufumanisa:
· bangaphi abantu abayeka ukutshaya kangangeenyanga ezintandathu ubuncinane;kwaye
· bangaphi abantu abaneziphumo ezingafunekiyo, ekunikwe ingxelo ngazo emva kweveki enye yokusetyenziswa.
Khangela umhla: Sifake ubungqina obupapashwe ukuya kuthi ga kwi-1st kaJulayi 2022.
Oko sikufumeneyo
Sifumene izifundo ezingama-78 ezibandakanya abantu abadala abangama-22,052 abatshayayo.Izifundo zithelekisa i-e-cigarettes kunye:
• unyango endaweni inikotini, ezifana neziziba okanye iintsini;
· varenicline (iyeza lokunceda abantu bayeke ukutshaya);
I-e-cigarettes ngaphandle kwe-nicotine;
· ezinye iindidi ze-nicotine-eziqulethe i-e‐cigarettes (umz. izixhobo ze-pod, izixhobo ezitsha);
· inkxaso yokuziphatha, enjengengcebiso okanye iingcebiso;okanye
· akukho nkxaso yokuyeka ukutshaya.
Uninzi lwezifundo zenzeke e-USA (izifundo ze-34), i-UK (16), kunye ne-Italy (8).
Zithini iziphumo zophononongo lwethu?
Abantu kunokwenzeka ukuba bayeke ukutshaya kangangeenyanga ezintandathu besebenzisa i-nicotine e-cigarettes kunokusebenzisa unyango lokubuyisela inikotini (izifundo ezi-6, abantu abangama-2378), okanye i-e-cigarettes ngaphandle kwe-nicotine (izifundo ezi-5, abantu be-1447).
I-Nicotine e-cigarettes inokunceda abantu abaninzi ukuba bayeke ukutshaya kunokuba kungabikho nkxaso okanye inkxaso yokuziphatha kuphela (izifundo ze-7, abantu be-3126).
Kubantu abali-100 abasebenzisa i-nicotine e-cigarettes ukuyeka ukutshaya, i-9 ukuya kwi-14 inokuyeka ngempumelelo, xa kuthelekiswa nabantu abayi-6 kuphela kwi-100 abasebenzisa unyango lwe-nicotine-replacement, isi-7 se-100 usebenzisa i-e-cigarettes ngaphandle kwe-nicotine, okanye i-4 yabantu abayi-100 abangenayo. inkxaso okanye inkxaso yokuziphatha kuphela.
Asiqinisekanga ukuba kukho umahluko phakathi kweziphumo ezingafunekiyo ezenzekayo kusetyenziswa i-nicotine e-cigarettes xa kuthelekiswa nonyango lokutshintsha nicotine, akukho nkxaso okanye inkxaso yokuziphatha kuphela.Kwakukho ubungqina bokuba iziphumo ezingafunekiyo ezingabalulekanga zazixhaphake kakhulu kumaqela afumana i-nicotine e-cigarettes xa kuthelekiswa nenkxaso okanye inkxaso yokuziphatha kuphela.Amanani aphantsi eziphumo ezingafunekiyo, kubandakanywa neziphumo ezibi ezingafunwayo, zixelwe kwizifundo ezithelekisa i-nicotine e-cigarettes kunye nonyango lokubuyisela i-nicotine.Akukho mahluko ukuba zininzi kangakanani iziphumo ezingafunekiyo eziyingozi ezenzeka kubantu abasebenzisa i-nicotine e-cigarettes xa kuthelekiswa ne-e-cigarettes ngaphandle kwe-nicotine.
Iziphumo ezingafunekiyo ezixelwe rhoqo nge-nicotine e-cigarettes yayingumqala okanye ukucaphuka komlomo, intloko ebuhlungu, ukukhohlela kunye nokuziva ugula.Ezi ziphumo ziye zancipha ngokuhamba kwexesha njengoko abantu baqhubeka nokusebenzisa i-nicotine e-cigarettes.
Zithembeke kangakanani ezi ziphumo?
Iziphumo zethu zisekelwe kwizifundo ezimbalwa kwiziphumo ezininzi, kwaye kwezinye iziphumo, idatha yahluka ngokubanzi.
Sifumene ubungqina bokuba i-nicotine e-cigarettes inceda abantu abaninzi ukuba bayeke ukutshaya kunonyango lokubuyisela i-nicotine.I-nikotini e-cigarettes mhlawumbi inceda abantu abaninzi ukuba bayeke ukutshaya kune-e-cigarettes ngaphandle kwe-nicotine kodwa izifundo ezininzi zisafuneka ukuqinisekisa oku.
Uphononongo oluthelekisa i-nicotine e-cigarettes kunye nokuziphatha okanye akukho nkxaso lubonise amazinga aphezulu okuyeka kubantu abasebenzisa i-nicotine e-cigarettes, kodwa babonelele ngedatha ethile encinci ngenxa yemibandela yoyilo lokufunda.
Uninzi lweziphumo zethu zeziphumo ezingafunekiyo zinokutshintsha xa kukho ubungqina obuninzi.
Imiyalezo ephambili
I-Nicotine e-cigarettes inokunceda abantu ukuba bayeke ukutshaya kangangeenyanga ezintandathu.Ubungqina bubonisa ukuba basebenza ngcono kunonyango lokubuyisela inikotini, kwaye mhlawumbi ngcono kune-e-cigarettes ngaphandle kwe-nicotine.
Bangasebenza bhetele kunokuba bangabikho nkxaso, okanye inkxaso yokuziphatha yodwa, kwaye abanako ukudibanisa nemiphumo emibi engafunekiyo.
Nangona kunjalo, sisadinga ubungqina obuninzi, ngakumbi malunga neziphumo zeentlobo ezintsha ze-e-cigarettes ezinokuhanjiswa kwe-nicotine engcono kuneentlobo zakudala ze-e-cigarettes, njengoko ukuhanjiswa kwe-nicotine engcono kunokunceda abantu abaninzi bayeke ukutshaya.
Ixesha lokuposa: Nov-23-2022
