Efficacy and Safety of E-Cigarettes for Smoking Cessation - E3

Mar 30, 2020
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Presenter/Author:
Mark J. Eisenberg, MD, MPH, FACC
Author/Summarized by Author:
Anthony A. Bavry, MD,MPH,FACC
Summary Reviewer:
Deepak L. Bhatt, MD, MPH, MBA, FACC
Trial Sponsor:
Canadian Institutes of Health Research
Date Presented:
03/30/2020
Original Posted Date:
03/30/2020
References

Contribution To Literature:

The E3 trial showed that nicotine e-cigarettes plus counseling were superior to counseling alone at smoking cessation.

Description:

The goal of the trial was to evaluate e-cigarettes compared with counseling on smoking cessation.



Study Design

  • Randomized
  • Parallel

Active smokers who were motivated to stop smoking were randomized to nicotine e-cigarettes plus counseling (n = 128) versus non-nicotine e-cigarettes plus counseling (n = 127) versus counseling alone (n = 121).

  • Total number of enrollees: 376
  • Duration of follow-up: 12 weeks
  • Mean patient age: 52 years
  • Percentage female: 47%

Inclusion criteria:

  • Active smokers willing to stop smoking

Other salient features/characteristics:

  • Mean years smoked: 35
  • Mean cigarettes per day: 21

Principal Findings:

The primary outcome, point prevalence abstinence at 12 weeks, was 22% in the nicotine e-cigarette group versus 17% in the non-nicotine e-cigarette group versus 9% in the counseling alone group (nicotine e-cigarette vs. counseling; relative risk [RR] 2.4, 95% confidence interval [CI] 1.3-4.6, non-nicotine e-cigarette vs. counseling; RR 1.9, 95% CI 1.0-3.8).

Secondary outcomes:

  • Cigarettes smoked per day: 8 in the nicotine e-cigarette group versus 10 in the non-nicotine e-cigarette group versus 14 in the counseling alone group (nicotine e-cigarette vs. counseling; mean difference -5.7, 95% CI -8.0 to -3.3, non-nicotine e-cigarette vs. counseling; mean difference -3.6, 95% CI -6.3 to -1.0)
  • Continuous abstinence: 5% in the nicotine e-cigarette group versus 3% in the non-nicotine e-cigarette group versus 1% in the counseling alone group (nicotine e-cigarette vs. counseling; RR 5.7, 95% CI 0.7 to 46.4, non-nicotine e-cigarette vs. counseling; RR 3.8, 95% CI 0.4 to 33.6)

Interpretation:

Among active smokers, nicotine e-cigarettes plus counseling were superior to counseling alone at smoking cessation. Non-nicotine e-cigarettes plus counseling had a more modest effect on smoking cessation compared with counseling alone. Despite improvements, continuous abstinence remained low for all groups (≤5%).

References:

Presented by Dr. Mark J. Eisenberg at the American College of Cardiology Virtual Annual Scientific Session Together With World Congress of Cardiology (ACC 2020/WCC), March 30, 2020.

Clinical Topics: Cardiovascular Care Team, Prevention, Smoking

Keywords: acc20, ACC Annual Scientific Session, Counseling, Electronic Nicotine Delivery Systems, Nicotine, Primary Prevention, Risk, Smoke, Smoking, Smoking Cessation, Tobacco Products, Tobacco Use Cessation


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