Dr Lynne Dawkins Drugs and Addictive Behaviours Research Group DABRG School of Psychology httpwwwuelacukpsychologyresearchdrugs SSA York November 2014 Disclosures Ecigarette Industry ID: 707314
Download Presentation The PPT/PDF document "E-cigarettes: Craving, Quitting & Ad..." is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.
Slide1
E-cigarettes: Craving, Quitting & Addictive Potential - keeping up with a rapidly evolving phenomena
Dr. Lynne DawkinsDrugs and Addictive Behaviours Research Group (DABRG), School of Psychologyhttp://www.uel.ac.uk/psychology/research/drugs
SSA, York, November 2014Slide2
Disclosures
E-cigarette Industry: Research fundingConference fundingReceived products for research
Tobacco Industry:
No conflict of interest
Pharmaceutical Industry:
No conflict of interestSlide3
Overview
Introduction to E-cigarettes (EC)Effects on craving & withdrawal symptomsBlood nicotine deliveryAddictivenessEffectiveness for smoking cessationSlide4
First Generation ECSlide5
Second Generation ECSlide6
Third Generation EC (‘
mods’)Slide7
Effects on Craving & Withdrawal Symptoms (WS)
EC (1st gen) can reduce craving & WS in deprived smokers; not as effective as tobacco cigarettes
(
Bullen
et al., 2010,
Tob
Con, 19
;
Vansickel
et al., 2010,
Can
Epid
Bio
Prev
, 19
)
Placebo (0mg nicotine)
EC
(1
st
gen) also associated with decline in craving after 5
mins
.
(Dawkins et al., 2012,
Add
Beh
, 37
)Slide8
Novice users’ experiences of EC use over one week
‘...I nearly fell out of a tree about 60 foot up and it was a real adrenaline boost and I needed something to take that away...that was the only time it really didn’t kick, you know, the craving away.’‘I was sat in this French cafe and there’s just people all around me smoking and it’s like, nah, I just need to get out of here now... It (the EC) just wasn’t taking the edge off it’
Lawson, Cahill & Dawkins (2013);
UKNSCC poster Slide9
Craving and WS:
2nd generation (refillable) devices
Lower
craving
& WS after using nicotine vs. placebo (2
nd
gen)
EC
(Dawkins, Turner & Crowe, 2013;).
Disposable
cigalike
vs. refillable device: both equally effective at reducing craving and WS
(Dawkins et al.,
under review)Slide10
1st
vs. 3rd generation devices
23 experienced EC users used a 1
st
gen
cartomiser
and 3
rd
gen device
In 3
rd
generation condition:
‘Craving to
vape
’ lower
(p<0.001)
Satisfaction and hit higher
(p<0.01)
Plasma nicotine levels higher at all time points
(p<0.001)
(
Farsalinos
et al., 2014)Slide11
EC: Blood nicotine delivery
Effective nicotine delivery with 1st generation cartomiser
device in 14 regular users
Dawkins & Corcoran (2014),
Psychopharmacology, vol. 231Slide12
Nicotine delivery: 1st vs. 3
rd generation device
Farsalinos
et al. (2014),
Scientific Reports, vol. 4Slide13
EC addictiveness
EC: slower speed of nicotine deliveryTobacco contains additives to increase addictionVapers reported longer time to first vape vs. time to first cigarette
30% had tried to quit
vaping
; mostly ‘not very successful’
(Dawkins et al., 2013;
Addiction, 106
)Slide14
EC vs
tobacco cigarettes (TC) in a multiple choice procedure (MCP)
Crossover value was significantly higher for 10 TC puffs ($1.50) compared with 10 EC puffs ($1.06).
Vansickel
, Weaver &
Eissenberg
, 2012,
Addiction, 107Slide15
Economic demand for EC vs. TC
Vapers had a lower unit price than smokers at breakpoint – i.e. smokers will pay more for their puffs
Campbell , Dawkins et al.,
in prepSlide16
Smoking Cessation
In 8 cross-sectional studies of vapers:42-99% of ex-smokers stated that EC had helped them to quit smoking
60-86% of smokers stated that EC had helped them to reduce no. of cigs per day
.
Dawkins
(2013)
Addiction, 108
;
Etter
(2010)
BMC Public
Health
,
10
;
Etter
(2011) A
ddiction, 106;
Farsalinos
(2013)
Int J
Envir
Res
& Pub
Health
;
Foulds
(2011)
Int J Clin
Pract
, 65;
Goniewicz
(2013)
Drug
Alc
Rev
, 32;
Kralikova
(2013),
Chest
, 144;
Siegel (2011)
Am J
Prev
Med, 40Slide17
Randomised Controlled Trials (RCTs):
‘Categoria
’ 23mg/ml nicotine EC vs. 17mg/ml nicotine EC vs. no nicotine EC
300 smokers (not intending to quit)
1 year abstinence rates: 13%, 9% and 4%
(
Caponnetto
et al., 2013)
‘Elusion’ 16mg/ml nicotine EC vs. no nicotine EC vs. nicotine patch
657 smokers followed up over 6 months
6 month abstinence rates: 7.3%, 4.1% and 5.8%
(
Bullen
et al., 2014)Slide18
Issues with RCTs:
ExpensiveTime-consuming
Out of date quickly in a rapidly changing market with fast moving technology
Ecologically valid? Not reflective of what actually happens (EC users do not stick to a single product and liquid)Slide19
Conclusions
EC can help
to alleviate craving
and WS...
...and raise blood nicotine levels
Craving relief, nicotine delivery & addictiveness all lower in EC
vs
TC
RCTs suggest e-cigs
at least
as effective as NRT...
...but trials with newer products needed
Effectiveness for cessation will depend on a host of political, regulatory, technological and sociocultural factorsSlide20
AcknowledgementsJohn TurnerKirstie Soar
Catherine KimberVictoria LawsonSharon CahillEaodine CroweOlivia CorcoranMaya Campbell