Papel do cigarro eletrónico na cessação tabágica: uma revisão baseada na evidência

Abstract

Objectives: To determine if electronic cigarettes are effective in smoking cessation. Data sources: MEDLINE databases; National Clearinghouse; Canadian Medical Association Practice Guidelines InfoBase; Guidelines Finder of the National Electronic Library for Health in the British NHS; Database of Abstracts of Reviews of Effectiveness - Centre for Reviews and Dissemination; Bandolier; The Cochrane Library; Index of Portuguese Medical Journals. Review methods: Articles published between 01/07/2004 and 30/06/2014 using the MeSH term �_~smoking cessation', the English terms �_~electronic cigarette(s)', �_~e-cigarette(s)', �_~e-cig(s)' and the Portuguese terms �_~cessa��ǜo tabǭgica' and �_~cigarro(s) ele(c)tr��nico(s)'. Studies that evaluated the smoking cessation in smokers exposed and not exposed to electronic cigarettes were included. �_~Strength-of-Recommendation Taxonomy', �_~Jadad' and �_~Newcastle-Ottawa' scales were used to assess the quality of the studies and the strength of recommendations. Results: The search produced a list of 2,076 articles. Ten articles were excluded as duplicates, 2,005 were excluded after reading the title because they were not directly related to the topic, 47 were excluded after reading the summary, and 11 after reading the full text because they did not meet the inclusion criteria. Three articles were included in this review. They were a systematic review, which included nine original studies (Level of Evidence (LE) 2), a classic review (LE 3), whose conclusions were unfavorable to the use of electronic cigarettes, and one cross-sectional study, which showed an increased use of electronic cigarettes compared to other therapies among those who stopped smoking (LE 3). Conclusions: Most studies found no association between use of electronic cigarettes and smoking cessation. The authors concluded that its use does not seem to play a beneficial role in smoking cessation (Strength of Recommendation B). Given the rapid expansion and growing popularity of these products, better quality studies are needed. constitui uma alternativa no apoio �� cessa��ǜo tabǭgica (CT). Fontes de dados: Bases de dados MEDLINE; National Clearinghouse; Canadian Medical Association Practice Guidelines InfoBase; Guidelines Finder da National Electronic Library for Health do NHS britǽnico; Database of Abstracts of Reviews of Effectiveness - Centre for Reviews and Dissemination; Bandolier; The Cochrane Library; �_ndex de Revistas MǸdicas Portuguesas. MǸtodos de revisǜo: Pesquisa de artigos publicados entre 01/07/2004 e 30/06/2014, utilizando o termo MeSH smoking cessation, os termos electronic cigarette(s), e-cigarette(s), e-cig(s) e em portuguǦs �_ocessa��ǜo tabǭgica�__ e �_ocigarro(s) ele(c)tr��nico(s)�__. Foram inclu��dos estudos que avaliassem a CT em fumadores expostos e nǜo expostos ao CE. As escalas Strength-of-Recommendation Taxonomy, Jadad e Newcastle-Ottawa foram utilizadas para avaliar a qualidade dos estudos e a for��a de recomenda��ǜo. Resultados: Da pesquisa resultaram 2.076 artigos; 10 foram exclu��dos por serem repetidos, 2.005 ap��s leitura do t��tulo por nǜo estarem relacionados diretamente com o tema, 47 ap��s leitura do resumo e 11 ap��s leitura integral por nǜo satisfazerem os critǸrios de inclusǜo. Foram assim inclu��dos trǦs artigos: uma revisǜo sistemǭtica que incluiu nove estudos originais (N��vel de EvidǦncia (NE) 2); uma revisǜo clǭssica (NE 3), cujas conclus��es foram desfavorǭveis �� utiliza��ǜo dos CE; e um estudo transversal que mostrou uma maior utiliza��ǜo de CE em rela��ǜo a outras terapǦuticas entre aqueles que atingiram CT (NE 3). Conclus��es: A maioria dos trabalhos nǜo encontrou associa��ǜo entre o uso de CE e a CT. Os autores consideram que o seu uso nǜo parece desempenhar um papel benǸfico na CT (For��a de Recomenda��ǜo B). Dada a rǭpida expansǜo e crescente popularidade destes produtos, sǜo necessǭrios estudos de melhor qualidade