Abstract
Aim. To systematize the data on the problem of patients who do not quit nicotine use and to answer the question: are alternative sources of nicotine delivery significantly less harmful than continuing to smoke traditional cigarettes for smokers who are not motivated to quit? To search for information, the studies were systematized according to the rules for preparing a systematic review according to the PICO requirements: Patients (P) – adults who smoke cigarettes; Intervention (I) – switching from cigarettes to ECs or ESDTs; Comparison (C) – participants who continue to smoke; Outcomes (O) – change in biomarkers of exposure and biomarkers of clinical risk.
Methods. The following keywords were used for the search. The influence of various factors on smoking cessation and relief of symptoms when switching to ECs: randomized controlled trial, smoking cessation, hospitalization, quitting tobacco smoking, quitting smoking, heated tobacco product. Pathogenetic effects of cigarette smoke on the body: cigarette smoke, tobacco products, nicotine delivery devices, cardiovascular system, risk, parameters, reward, cigarette. The following resources were used for the search: Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, ClinicalTrials.gov, Elibrary, Scopus. The obtained materials were entered into Rayyan for systematization and primary analysis. First, duplicate articles were excluded, then articles were excluded by titles and/or abstracts. Editorials, comments, letters, news articles, studies that have not undergone peer review, including conference abstracts, unpublished clinical trials and articles from preprints were excluded from the study.
Results. The analyzed data report that the transition to alternative nicotine delivery systems (ANDS), although not helping to completely quit nicotine, reduces the impact of toxicants on the body of former smokers of classic cigarettes. ANDS contain fewer harmful and potentially harmful substances compared to tobacco smoke and have less cytotoxicity. However, they still contain carcinogenic substances, can cause oxidative stress and inflammation, but to a lesser extent than classic cigarettes. Complete cessation of smoking and nicotine-containing products remains the best option for maintaining health. At the same time, the study showed that not all patients are able to quit nicotine even with counseling and additional therapy, which demonstrates the need for flexible approaches to reduce harm in such patients.
Keywords: electronic nicotine delivery systems, tobacco heating system, alternative nicotine delivery sources, cardiovascular diseases, respiratory diseases, oncological diseases, smoking.
Methods. The following keywords were used for the search. The influence of various factors on smoking cessation and relief of symptoms when switching to ECs: randomized controlled trial, smoking cessation, hospitalization, quitting tobacco smoking, quitting smoking, heated tobacco product. Pathogenetic effects of cigarette smoke on the body: cigarette smoke, tobacco products, nicotine delivery devices, cardiovascular system, risk, parameters, reward, cigarette. The following resources were used for the search: Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, ClinicalTrials.gov, Elibrary, Scopus. The obtained materials were entered into Rayyan for systematization and primary analysis. First, duplicate articles were excluded, then articles were excluded by titles and/or abstracts. Editorials, comments, letters, news articles, studies that have not undergone peer review, including conference abstracts, unpublished clinical trials and articles from preprints were excluded from the study.
Results. The analyzed data report that the transition to alternative nicotine delivery systems (ANDS), although not helping to completely quit nicotine, reduces the impact of toxicants on the body of former smokers of classic cigarettes. ANDS contain fewer harmful and potentially harmful substances compared to tobacco smoke and have less cytotoxicity. However, they still contain carcinogenic substances, can cause oxidative stress and inflammation, but to a lesser extent than classic cigarettes. Complete cessation of smoking and nicotine-containing products remains the best option for maintaining health. At the same time, the study showed that not all patients are able to quit nicotine even with counseling and additional therapy, which demonstrates the need for flexible approaches to reduce harm in such patients.
Keywords: electronic nicotine delivery systems, tobacco heating system, alternative nicotine delivery sources, cardiovascular diseases, respiratory diseases, oncological diseases, smoking.
For citation:Maksimov M.L., Danilova M.S., Shikaleva A.A., Zvegintzeva A.A. Using alternative nicotine products to reduce harm to patients not refusing nicotine consumption. Narrative review. Clinical review for general practice. 2024; 5 (11): 85–100 (In Russ.). DOI: 10.47407/kr2024.5.11.00521
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