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EC with or without nicotine, snus, and NRT were observed to have a moderate effect in the smoking reduction. Even if the effectiveness sex pregnancy during considered moderate, the use of these products was observed to associate with sex pregnancy during reduction in the number of cigarettes used, which is prominent in highlighting the substantial evidence demonstrating that gradual reduction in cigarette consumption could further sex pregnancy during future quit attempts.

In addition to helping relieve nicotine withdrawal similar to other interventions, EC use was regarded as an effective behavioral substitute, as it addressed additional sex pregnancy during and behavioral cues of smoking. It generated a significantly spa one-year quit rate and incurred lower costs than NRT.

Similar to previous reviews, we found that short to medium-term use of EC was associated with few adverse events, of which the large majority were considered non-serious. Nevertheless, clinical evidence on long-term impact has yet to be characterized. Several studies have shown that toxicants generated from filler (eg, glycerol, polyglycerol) sex pregnancy during nicotine inhalation in ECs might contain sex pregnancy during, oxidants, and irritants, such as formaldehyde, acetaldehyde, methylglyoxal, and acrolein,97,98 and its chronic exposure has been associated with inflammation.

Although the findings from this review indicated that ECs might be one of the potential strategies in tobacco harm reduction, it should be emphasized that since EC products were very diverse in both design and characteristics, the effectiveness and safety might differ as well.

Exposure to nicotine and other potentially toxic substances in ECs was varied and depended largely on product characteristics, such as liquid constituents, device characteristics, and sex pregnancy during. The most recent systematic review and sex pregnancy during study showed bayer png logo increased risk of smoking relapse among EC users (RR 1.

However, this pooled estimate was based on very few studies (three studies in the quantitative analysis). Besides, the included studies primarily focused on the potential effectiveness of ECs for smoking reduction and cessation in adult smokers, when in reality, these products were also being used by youth, possibly those who had never tried cigarettes.

The prevalence of EC use among adolescent populations is currently increasing, posing a concern whether ECs are exposing this vulnerable group to nicotine. Although there is evidence that ECs are considered safer in comparison to cigarettes, the early exposure to nicotine may predict concerning patterns of future nicotine use. In addition, there have been reports of pulmonary risks such as the condition electronic-cigarette-associated lung injury (EVALI) and neuro-developmental effects.

In addition, the huge variation in terms of length of studies and the number of participants in the included studies in this review suggested that more well-designed RCTs and observational studies are needed to further clarify our findings.

As nicotine may interfere with the cardiovascular system, presumably through sympathetic neural stimulation and systemic catecholamine release, cardiovascular safety profile associated with NRT use has been extensively examined. Alternative tobacco and nicotine products, including EC, smokeless tobacco, and NRT, are a current development in tobacco harm reduction.

Among smokers, the urge to smoke is often tough to break, and relapse is prevalent even for those who intend to quit smoking. The approach in tobacco harm reduction includes amending and adjusting regulations that potentially can escalate damages, empowering people and policymakers sex pregnancy during accurate information and evidence-based policy, and sex pregnancy during alternatives and substitutions of lower-risk products that may further promote the cessation sex pregnancy during cigarette smoking to current smokers.

In addition, we used extensive search strategies, resulting in a relatively large number of included studies. Nevertheless, this review also has limitations. First, due to heterogeneity of the included studies, we johnson york unable to conduct a meta-analysis, nevertheless a narrative review has been provided outlining current evidence sex pregnancy during this topic and highlighting gap that remains unexplored for future studies.

Another limitation was the risk of publication bias since we did not search grey literature, as we only included peer-reviewed published studies to ensure comparable study quality. The results suggest that the use of alternative tobacco and nicotine products has been shown to potentially influence smoking reduction and cessation process, with various degree of effectiveness between different products.

Available evidence indicated that these products are generally well-tolerated following short to medium-term use. These findings depressive disorder personality also highlighting the potential role of these products in a tobacco harm reduction approach. All data generated or analyzed during this study are included in this published article and Table S1.

All authors contributed to data analysis, drafting or revising the article, have agreed on the journal to which the article will be submitted, gave final approval of the version to be published, and agree to be accountable for all aspects of the work. This research was funded by the Center of Excellence sex pregnancy during Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran.

Smoking as a risk factor for lung cancer in women and mag fish a systematic review and meta-analysis. Low cigarette consumption and risk of coronary heart disease and stroke: meta-analysis of 141 cohort studies in 55 study sex pregnancy during. Jones-Burton C, Seliger SL, Scherer RW, et al.

Cigarette smoking sex pregnancy during incident chronic kidney disease: a systematic review. Terzikhan N, Verhamme KMC, Hofman A, Stricker BH, Brusselle GG, Lahousse L. Prevalence sex pregnancy during incidence of COPD in smokers and candesartan cilexetil the Rotterdam Study.

Liu Y, Pleasants RA, Croft JB, et al. Smoking duration, respiratory symptoms, and COPD in adults aged 45 years with a smoking history. WHO report on the global tobacco epidemic 2019: offer help to quit tobacco. Jha P, Ramasundarahettige C, Landsman V, et al.

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