Vaping cessation interventions: a systematic review and meta-analysis

Clinical Snapshot

Key Findings

• P Value: Not explicitly stated but CI excludes null

• Effect Size: OR 1.52 (statistically significant increase in cessation odds)

• Primary Outcome: 7-day point prevalence abstinence at 1-12 months follow-up

• Nnt Or Sensitivity: Moderate certainty evidence for 7-day abstinence, low certainty for continuous abstinence

• Confidence Interval: 95% CI 1.15 to 2.01

Clinical Application

Interventions appear feasible but limited evidence base restricts widespread implementation Relevant to Australian practice given TGA restrictions on nicotine vaping products and growing clinical need for cessation support. No PBS-listed vaping cessation aids currently available. Adults using e-cigarettes seeking cessation support, particularly those motivated to quit

Abstract

OBJECTIVE: Electronic nicotine delivery systems (ENDS), such as e-cigarettes, have surged in popularity. While long-term risks remain unclear, known dangers include nicotine addiction, E-cigarette or Vaping Use-Associated Lung Injury and potential extrapulmonary effects on the heart, immune system and neurodevelopment. Addressing ENDS addiction may require strategies akin to smoking cessation. However, evidence is lacking; there are no currently approved vaping-cessation aids. The objective of this review is to summarise the available literature addressing interventions for vaping cessation. DATA SOURCES AND STUDY SELECTION: A librarian-assisted search was conducted in MEDLINE, Embase and Scopus, as well as preprints in Europe PMC, Open Science Framework, and the grey literature searches until January 2024. Six included studies used self-report methods to determine the abstinence rate, while one study used cotinine-level-verified self-reported abstinence. We included randomised controlled trials (RCTs) that examine 'rates of vaping cessation' outcomes. An intention-to-treat approach was used for data extraction, and random-effects meta-analyses models were applied. DATA SYNTHESIS: Seven RCTs were included, which studied pharmacological therapy, digital interventions and/or educational content. The primary meta-analyses demonstrated a statistically significant increase in the odds of achieving 7-day point prevalence abstinence (PPA) (OR 1.52, 95% CI 1.15 to 2.01, number of participants=3244, moderate-certainty) and continuous abstinence (OR 2.71, 95% CI 1.31 to 5.61, number of participants=164, low-certainty) following intervention. A non-significant increase in odds was noted at 30-day PPA (OR 1.32, 95% CI 0.72 to 2.42, number of participants=1994, very low certainty). CONCLUSIONS: Vaping cessation interventions increase 7-day PPA rates at 1-12 months follow-up and this was consistent across prespecified subgroup analyses of the intervention type, outcome and duration of follow-up. More high-quality studies with reproducible findings are needed to enhance the certainty of the evidence and guide clinical interventions. PROSPERO REGISTRATION NUMBER: CRD42022383670.

References

1. 1.Heshmati, J., Pandey, A., Benjamen, J., Furqan, M., Salman, M., Visintini, S., Mullen, K. A., Guyatt, G., Pipe, A. L., & Mir, H. (2024). Vaping cessation interventions: a systematic review and meta-analysis. Tobacco Control. https://doi.org/10.1136/tc-2024-058798