Abstract
Ingemuva
Ugwayi we-elekthronikhi(ama-EC) amadivaysi kagesi aphathwa ngesandla akhiqiza i-aerosol ngokushisisa i-e-liquid.Abanye abantu ababhemayo basebenzisa ama-ECs ukuze bayeke noma banciphise ukubhema, nakuba ezinye izinhlangano, izinhlangano ezilwela amalungelo abantu kanye nabakhi benqubomgomo bengakukhuthazi lokhu, becaphuna ukuntuleka kobufakazi bokusebenza nokuphepha.Abantu ababhemayo, abahlinzeki bezempilo kanye nabalawuli bafuna ukwazi ukuthi ama-EC angasiza yini abantu bayeke ukubhema, nokuthi aphephile yini ukusetshenziselwa le njongo.Lesi isibuyekezo sokubuyekeza esenziwe njengengxenye yokubuyekezwa okuhleliwe okuphilayo.
Izinjongo
Ukuhlola ukusebenza kahle, ukubekezelelana, kanye nokuphepha kokusebenzisa ugwayi we-elekthronikhi (ama-EC) ukusiza abantu ababhema ugwayi ukuthi bafinyelele umgomo wokuyeka ukubhema isikhathi eside.
Sesha izindlela
Siseshe Irejista Ekhethekile Yeqembu Le-Cochrane Tobacco Addiction, i-Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, and PsycINFO to 1 July 2022, futhi sahlolwa futhi sathintwa ababhali bocwaningo.
Imibandela yokukhetha
Sifake izivivinyo ezilawulwa ngokungahleliwe (ama-RCT) kanye nokuhlola okungahleliwe okuphambanayo, lapho abantu ababhemayo babehlelwa ngokungahleliwe ku-EC noma kusimo sokulawula.Siphinde safaka nezifundo zokungenelela ezingalawulwa lapho bonke ababambiqhaza bathola ukungenelela kwe-EC.Ucwaningo bekufanele lubike ukunqanda ugwayi ezinyangeni eziyisithupha noma ngaphezulu noma idatha yezimpawu zokuphepha ngesonto elilodwa noma ngaphezulu, noma kokubili.
Ukuqoqwa nokuhlaziywa kwedatha
Silandele izindlela ezijwayelekile ze-Cochrane zokuhlola nokukhipha idatha.Imiphumela yethu eyinhloko yayiwukuyeka ukubhema ngemva kokulandela okungenani izinyanga eziyisithupha, izehlakalo ezimbi (ama-AEs), kanye nezenzakalo ezimbi kakhulu (ama-SAE).Imiphumela yesibili yayihlanganisa ingxenye yabantu abasasebenzisa umkhiqizo wocwaningo (EC noma i-pharmacotherapy) ezinyangeni eziyisithupha noma ngaphezulu ngemva kokungahleliwe noma ukuqala ukusetshenziswa kwe-EC, izinguquko ku-carbon monoxide (CO), umfutho wegazi (BP), izinga lokushaya kwenhliziyo, ukugcwala komoyampilo emthanjeni, amaphaphu. umsebenzi, kanye namazinga ama-carcinogens noma ama-toxicants, noma kokubili.Sisebenzise imodeli ye-Mantel-Haenszel enemiphumela engaguquki ukubala izilinganiso zobungozi (RRs) ngesikhawu sokuzethemba esingu-95% (CI) ngemiphumela engaqondakali.Ngemiphumela eqhubekayo, sibale umehluko wencazelo.Lapho kufaneleka khona, sihlanganise idatha ekuhlaziyweni kwe-meta.
Imiphumela esemqoka
Sifake izifundo eziqediwe ze-78, ezimele abahlanganyeli be-22,052, lapho i-40 yayingama-RCT.Izifundo eziyishumi nesikhombisa kwezingu-78 ezifakiwe bezizintsha kulokhu kubuyekezwa kokubuyekezwa.Ezifundweni ezifakiwe, silinganise ishumi (konke ngaphandle koyedwa obambe iqhaza ekuqhathaniseni kwethu okuyinhloko) engcupheni ephansi yokuchema sekukonke, ama-50 engcupheni enkulu iyonke (okubandakanya zonke izifundo ezingahleliwe), kanti okusele kusengozini engacacile.
Kwakukhona isiqiniseko esiphezulu sokuthi amazinga okuyeka ayephakeme kubantu abangahleliwe ku-nicotine EC kunalabo abangahleliwe ku-nicotine replacement therapy (NRT) (RR 1.63, 95% CI 1.30 kuya ku-2.04; I2 = 10%; Izifundo ze-6, abahlanganyeli be-2378).Ngamagama aphelele, lokhu kungase kuhumushele kwabanye abayekayo abane abengeziwe ngo-100 (95% CI 2 kuya ku-6).Kube nobufakazi bokuqiniseka okusesilinganisweni (kukhawulelwe ngokungaqondile) ukuthi izinga lokwenzeka kwama-AE lalifana phakathi kwamaqembu (RR 1.02, 95% CI 0.88 kuya ku-1.19; I2 = 0%; izifundo ezi-4, ababambiqhaza be-1702).Ama-SAE ayengavamile, kodwa kwakungekho ubufakazi obanele bokunquma ukuthi amanani ayehluka yini phakathi kwamaqembu ngenxa yokungaqondi kahle okukhulu (RR 1.12, 95% CI 0.82 kuya ku-1.52; I2 = 34%; izifundo ezingu-5, ababambiqhaza be-2411).
Kube nobufakazi obulinganiselwe bokuqinisekisa, obunqunyelwe ngokungaqondile, ukuthi amazinga okuyeka ayephakeme kubantu abangahleliwe ku-nicotine EC kune-non-nicotine EC (RR 1.94, 95% CI 1.21 kuya ku-3.13; I2 = 0%; Izifundo ezingu-5, abahlanganyeli be-1447) .Ngokwemibandela ephelele, lokhu kungase kuholele ekuyekeni okwengeziwe abayisikhombisa kwabangu-100 (95% CI 2 kuya ku-16).Kube nobufakazi obulinganiselwe bokuqinisekisa ukuthi akukho mehluko kuzinga lama-AE phakathi kwalawa maqembu (RR 1.01, 95% CI 0.91 kuya ku-1.11; I2 = 0%; izifundo ezingu-5, ababambiqhaza be-1840).Kube khona ubufakazi obanele bokunquma ukuthi amazinga e-SAE ahlukile yini phakathi kwamaqembu, ngenxa yokungaqondi kahle okungathi sína (RR 1.00, 95% CI 0.56 kuya ku-1.79; I2 = 0%; izifundo ezingu-8, ababambiqhaza abangu-1272).
Uma kuqhathaniswa nokusekelwa kokuziphatha kuphela / akukho ukwesekwa, amazinga okuyeka ayephakeme kubahlanganyeli abangahleliwe ku-nicotine EC (RR 2.66, 95% CI 1.52 kuya ku-4.65; I2 = 0%; Izifundo ze-7, abahlanganyeli be-3126).Ngokwemibandela ephelele, lokhu kumelela abanye ababili abayekayo kwabangu-100 (95% CI 1 kuya ku-3).Kodwa-ke, lokhu okutholakele bekunesiqiniseko esiphansi kakhulu, ngenxa yezinkinga zokungaqondile kanye nengozi yokuchema.Kube nobunye ubufakazi bokuthi ama-AE (angewona abucayi) ayevame kakhulu kubantu abangahleliwe ku-nicotine EC (RR 1.22, 95% CI 1.12 kuya ku-1.32; I2 = 41%, isiqiniseko esiphansi; izifundo ze-4, ababambiqhaza be-765) futhi, futhi, ayenele ubufakazi bokunquma ukuthi amazinga e-SAE ahluke yini phakathi kwamaqembu (RR 1.03, 95% CI 0.54 kuya ku-1.97; I2 = 38%; izifundo ezingu-9, abahlanganyeli be-1993).
Idatha evela ezifundweni ezingahleliwe yayihambisana nedatha ye-RCT.Ama-AE avame ukubikwa kwaba ukucasuka komphimbo/umlomo, ikhanda elibuhlungu, ukukhwehlela, nesicanucanu, okwakuvame ukushabalala ngokuqhubeka nokusetshenziswa kwe-EC.Izifundo ezimbalwa kakhulu ezibike idatha yeminye imiphumela noma iziqhathaniso, yingakho ubufakazi balokhu bunomkhawulo, kanti ama-CI avame ukuhlanganisa ukulimala okubalulekile emtholampilo kanye nenzuzo.
Iziphetho zababhali
Kunobufakazi obuqinisekile bokuthi ama-EC ane-nicotine akhuphuka amazinga okuyeka uma kuqhathaniswa ne-NRT kanye nobufakazi bokuqinisekisa ukuthi anyusa amazinga okuyeka uma kuqhathaniswa nama-EC ngaphandle kwe-nicotine.Ubufakazi obuqhathanisa i-nicotine EC nokunakekelwa okuvamile/akukho ukwelashwa nakho buphakamisa inzuzo, kodwa abuqiniseki kangako.Kudingeka izifundo ezengeziwe ukuze kuqinisekiswe usayizi womthelela.Izikhathi zokuzethemba zaziyingxenye enkulu yedatha yama-AEs, ama-SAE nezinye izimpawu zokuphepha, kungekho mehluko kuma-AEs phakathi kwe-nicotine ne-non-nicotine ECs naphakathi kwe-nicotine ECs ne-NRT.Sekukonke izehlakalo zama-SAE beziphansi kuzo zonke izingalo zokufunda.Asizange sithole ubufakazi bokulimala okukhulu okuvela ku-nicotine EC, kodwa ukulandelwa okude kakhulu kwakuyiminyaka emibili futhi inani lezifundo lalincane.
Umkhawulo oyinhloko wesisekelo sobufakazi uhlala unganembile ngenxa yenani elincane lama-RCT, ngokuvamile anamazinga aphansi emicimbi, kodwa amanye ama-RCT ayaqhubeka.Ukuqinisekisa ukuthi ukubuyekezwa kuyaqhubeka nokuhlinzeka ngolwazi lwakamuva kubenzi bezinqumo, lokhu kubuyekezwa kuwukubuyekezwa okuhlelekile okuphilayo.Senza ukusesha nyanga zonke, futhi isibuyekezo sibuyekezwa lapho ubufakazi obusha obubalulekile butholakala.Sicela ubheke Isizindalwazi se-Cochrane Sokubuyekezwa Okuhlelekile ukuze uthole isimo samanje sesibuyekezo.
Isifinyezo solimi olulula
Ingabe ugwayi we-electronic ungabasiza abantu ukuba bayeke ukubhema, futhi ingabe uba nemiphumela engadingeki lapho usetshenziselwa le njongo?
Yini ugwayi we-electronic?
Ugwayi we-elekthronikhi (ama-e‐cigarette) yizinto eziphathwayo ezisebenza ngokushisisa uketshezi oluvame ukuqukatha i-nicotine nezinongo.I-e-cigarettes ikuvumela ukuthi uhogele i-nicotine emhwamukeni kunokuba ubheme.Ngenxa yokuthi abawushisi ugwayi, ugwayi we-elekthronikhi awubeki abasebenzisi emazingeni afanayo amakhemikhali angabangela izifo kubantu ababhema ugwayi ovamile.
Ukusebenzisa i-e-cigarette ngokuvamile kwaziwa ngokuthi 'i-vaping'.Abantu abaningi basebenzisa i-e-cigarettes ukuze babasize bayeke ukubhema.Kulesi sibuyekezo sigxile kakhulu ku-e-cigarettes oqukethe i-nicotine.
Kungani senze lokhu kubuyekezwa kwe-Cochrane
Ukuyeka ukubhema kwehlisa amathuba okuba nomdlavuza wamaphaphu, isifo senhliziyo nezinye izifo eziningi.Abantu abaningi bakuthola kunzima ukuyeka ukubhema.Besifuna ukuthola ukuthi ukusebenzisa i-e-cigarettes kungabasiza yini abantu ukuthi bayeke ukubhema, futhi uma abantu abawusebenzisela le njongo baba nemiphumela engadingeki.
Senzeni?
Sifune izifundo ezibheka ukusetshenziswa kukagwayi we-elekhthronikhi ukusiza abantu bayeke ukubhema.
Sibheke izinhlolo ezilawulwa ngokungahleliwe, lapho ukwelashwa abantu abakuthola kwakunqunywa ngokungahleliwe.Lolu hlobo locwaningo luvamise ukunikeza ubufakazi obuthembeke kakhulu mayelana nemiphumela yokwelashwa.Siphinde sabheka izifundo lapho wonke umuntu athola ukwelashwa kwe-e-cigarette.
Sibe nentshisekelo yokuthola:
· bangaki abantu abayeke ukubhema okungenani izinyanga eziyisithupha;futhi
· bangaki abantu ababa nemiphumela engadingeki, okubikwe ngabo okungenani ngemva kwesonto elilodwa lokusetshenziswa.
Idethi yokusesha: Sifake ubufakazi obushicilelwe kuze kube umhlaka-1 Julayi 2022.
Esikutholile
Sithole izifundo ezingu-78 ezihlanganisa abantu abadala abangu-22,052 ababhemayo.Ucwaningo luqhathanise i-e-cigarettes nalokhu:
· Ukwelapha esikhundleni se-nicotine, njengama-patches noma izinsini;
· varenicline (umuthi wokusiza abantu ukuba bayeke ukubhema);
· ugwayi we-e ngaphandle kwe-nicotine;
· ezinye izinhlobo zikagwayi oqukethe i-nicotine (isb. amadivaysi e-pod, amathuluzi amasha);
· ukwesekwa kokuziphatha, njengeseluleko noma ukwelulekwa;noma
· akukho ukwesekwa kokuyeka ukubhema.
Izifundo eziningi zenzeke e-USA (izifundo ezingama-34), e-UK (16), nase-Italy (8).
Iyini imiphumela yokubuyekeza kwethu?
Abantu maningi amathuba okuthi bayeke ukubhema okungenani izinyanga eziyisithupha besebenzisa i-nicotine e-cigarettes kunokusebenzisa i-nicotine replacement therapy (izifundo eziyisi-6, abantu abangama-2378), noma ama-e-cigarette ngaphandle kwe-nicotine (izifundo ezi-5, abantu abayi-1447).
I-Nicotine e-cigarettes ingasiza abantu abaningi ukuba bayeke ukubhema kunokungasekelwe noma ukwesekwa kokuziphatha kuphela (izifundo ezingu-7, abantu be-3126).
Kubantu abayikhulu abasebenzisa i-nicotine e-cigarettes ukuze bayeke ukubhema, abayi-9 kuye kwayi-14 bangayeka ngempumelelo, uma kuqhathaniswa nabantu abayi-6 kuphela kwabayi-100 abasebenzisa i-nicotine-replacement therapy, abangu-7 kwabayi-100 abasebenzisa i-e-cigarette ngaphandle kwe-nicotine, noma abantu abane kwabayikhulu abangenayo. ukwesekwa noma ukwesekwa kokuziphatha kuphela.
Asiqiniseki uma kunomehluko phakathi kokuthi mingaki imiphumela engadingeki eyenzeka kusetshenziswa ugwayi we-nicotine e-nicotine uma kuqhathaniswa nokwelashwa esikhundleni se-nicotine, akukho ukusekelwa noma ukwesekwa kokuziphatha kuphela.Kube nobunye ubufakazi bokuthi imiphumela engadingeki engeyona embi kakhulu yayivame kakhulu emaqenjini athola i-nicotine e-cigarettes uma kuqhathaniswa nokungasekelwa noma ukwesekwa kokuziphatha kuphela.Izinombolo eziphansi zemiphumela engadingeki, okuhlanganisa nemiphumela engathi sína engadingeki, zabikwa ezifundweni eziqhathanisa ne-nicotine e-cigarettes nokwelashwa okushintshwa kwe-nicotine.Cishe awukho umehluko ekutheni mingaki imiphumela engemibi engadingeki eyenzekayo kubantu abasebenzisa i-nicotine e-cigarettes uma kuqhathaniswa ne-e-cigarettes ngaphandle kwe-nicotine.
Imiphumela engadingeki ebikwe kaningi ngogwayi we-nicotine kwaba ukucasuka komphimbo noma umlomo, ikhanda elibuhlungu, ukukhwehlela nokuzizwa ugula.Le miphumela yehla ngokuhamba kwesikhathi njengoba abantu beqhubeka nokusebenzisa i-nicotine e-cigarettes.
Ithembeke kangakanani le miphumela?
Imiphumela yethu isuselwe ocwaningweni olumbalwa lwemiphumela eminingi, futhi kweminye imiphumela, idatha yahluka kakhulu.
Sithole ubufakazi bokuthi i-nicotine e-cigarettes isiza abantu abaningi ukuba bayeke ukubhema kune-nicotine replacement therapy.I-Nicotine e-cigarettes cishe isiza abantu abaningi ukuba bayeke ukubhema kunogwayi be-e-cigarette abangenawo nicotine kodwa kusadingeka ucwaningo olwengeziwe ukuze kuqinisekiswe lokhu.
Ucwaningo oluqhathanisa ne-nicotine e-cigarettes nokwesekwa kokuziphatha noma okungekho lutho futhi lubonise amazinga aphezulu okuyeka kubantu abasebenzisa i-nicotine e-cigarettes, kodwa bahlinzeka ngedatha ethile encane ngenxa yezinkinga zokuklama ucwaningo.
Iningi lemiphumela yethu yemiphumela engadingeki ingashintsha lapho ubufakazi obengeziwe butholakala.
Imilayezo engukhiye
I-Nicotine e-cigarettes ingasiza abantu ukuthi bayeke ukubhema okungenani izinyanga eziyisithupha.Ubufakazi bubonisa ukuthi zisebenza kangcono kunokwelashwa esikhundleni se-nicotine, futhi mhlawumbe kangcono kunogwayi be-e-cigarette ngaphandle kwe-nicotine.
Bangase basebenze kangcono kunokungatholi ukwesekwa, noma ukwesekwa kokuziphatha kuphela, futhi bangase bangahlotshaniswa nemiphumela emibi engadingeki.
Kodwa-ke, sisadinga ubufakazi obengeziwe, ikakhulukazi mayelana nemiphumela yezinhlobo ezintsha zikagwayi we-e-cigarette ezinokulethwa okungcono kwe-nicotine kunezinhlobo ezindala zikagwayi we-e-cigarette, njengoba ukulethwa kwe-nicotine okungcono kungasiza abantu abaningi ukuba bayeke ukubhema.
Isikhathi sokuthumela: Nov-23-2022
