title: Electronic Cigarettes Efficacy and Safety at 12 Months: Cohort Study.
abstract: OBJECTIVE
  To evaluate the safety and efficacy as a tool of smoking cessation of electronic cigarettes (e-cigarettes), directly comparing users of e-cigarettes only, smokers of tobacco cigarettes only, and smokers of both.
  
  
  METHODS
  Prospective cohort study. Final results are expected in 2019, but given the urgency of data to support policies on electronic smoking, we report the results of the 12-month follow-up.
  
  
  METHODS
  Direct contact and structured questionnaires by phone or via internet.
  
  
  METHODS
  Adults (30-75 years) were included if they were smokers of ≥1 tobacco cigarette/day (tobacco smokers), users of any type of e-cigarettes, inhaling ≥50 puffs weekly (e-smokers), or smokers of both tobacco and e-cigarettes (dual smokers). Carbon monoxide levels were tested in a sample of those declaring tobacco smoking abstinence.
  
  
  METHODS
  Sustained smoking abstinence from tobacco smoking at 12 months, reduction in the number of tobacco cigarettes smoked daily.
  
  
  RESULTS
  We used linear and logistic regression, with region as cluster unit.
  
  
  RESULTS
  Follow-up data were available for 236 e-smokers, 491 tobacco smokers, and 232 dual smokers (overall response rate 70.8%). All e-smokers were tobacco ex-smokers. At 12 months, 61.9% of the e-smokers were still abstinent from tobacco smoking; 20.6% of the tobacco smokers and 22.0% of the dual smokers achieved tobacco abstinence. Adjusting for potential confounders, tobacco smoking abstinence or cessation remained significantly more likely among e-smokers (adjusted OR 5.19; 95% CI: 3.35-8.02), whereas adding e-cigarettes to tobacco smoking did not enhance the likelihood of quitting tobacco and did not reduce tobacco cigarette consumption. E-smokers showed a minimal but significantly higher increase in self-rated health than other smokers. Non significant differences were found in self-reported serious adverse events (eleven overall).
  
  
  CONCLUSIONS
  Adding e-cigarettes to tobacco smoking did not facilitate smoking cessation or reduction. If e-cigarette safety will be confirmed, however, the use of e-cigarettes alone may facilitate quitters remaining so.
  
  
  BACKGROUND
  NCT01785537.
authors.affiliation: Department of Medicine and Aging Sciences, University of Chieti, via dei Vestini 5, 66013, Chieti, Italy; Local Health Unit of Pescara, Via Renato Paolini 47, 65100, Pescara, Italy; "University G. d'Annunzio" Foundation, Via Colle dell'Ara, 66013, Chieti, Italy; Regional Healthcare Agency of Abruzzo, Via Attilio Monti 9, 65127, Pescara, Italy.
authors.forename: Lamberto
authors.initials: L
authors.lastname: Manzoli
authors.affiliation: Department of Medicine and Aging Sciences, University of Chieti, via dei Vestini 5, 66013, Chieti, Italy; Local Health Unit of Pescara, Via Renato Paolini 47, 65100, Pescara, Italy.
authors.forename: Maria Elena
authors.initials: ME
authors.lastname: Flacco
authors.affiliation: Department "G. F. Ingrassia"- Hygiene and Public Health, University of Catania, Piazza Università 2, 95131, Catania, Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: Fiore
authors.affiliation: Department of Clinical Sciences and Community Health, University of Milan, Via Vanzetti 5, 20133, Milan, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: La Vecchia
authors.affiliation: Department of Public Health and Infectious Diseases, Sapienza University of Rome, Viale Regina Elena 324, 00161, Roma, Italy.
authors.forename: Carolina
authors.initials: C
authors.lastname: Marzuillo
authors.affiliation: Department of Public Health Sciences, University of Turin, Via Santena 5/bis, Turin, 10124, Italy.
authors.forename: Maria Rosaria
authors.initials: MR
authors.lastname: Gualano
authors.affiliation: Department of Movement Sciences and Wellbeing, University Parthenope of Neaples, Via Medina 40, 80133, Napoli, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Liguori
authors.affiliation: Local Health Authority of Lanciano-Vasto-Chieti, Via Martiri Lancianesi, 66100, Chieti, Italy.
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Cicolini
authors.affiliation: Department of Medicine and Aging Sciences, University of Chieti, via dei Vestini 5, 66013, Chieti, Italy; "University G. d'Annunzio" Foundation, Via Colle dell'Ara, 66013, Chieti, Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Capasso
authors.affiliation: Local Health Unit of Pescara, Via Renato Paolini 47, 65100, Pescara, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: D'Amario
authors.affiliation: Institute of Public Health, Università Cattolica del Sacro Cuore, Rome, Largo Francesco Vito, 1, 00168, Roma, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Boccia
authors.affiliation: Department of Public Health Sciences, University of Turin, Via Santena 5/bis, Turin, 10124, Italy.
authors.forename: Roberta
authors.initials: R
authors.lastname: Siliquini
authors.affiliation: Institute of Public Health, Università Cattolica del Sacro Cuore, Rome, Largo Francesco Vito, 1, 00168, Roma, Italy; Italian Institute of Health, Viale Regina Elena 299, 00161, Rome, Italy.
authors.forename: Walter
authors.initials: W
authors.lastname: Ricciardi
authors.affiliation: Department of Public Health and Infectious Diseases, Sapienza University of Rome, Viale Regina Elena 324, 00161, Roma, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Villari
mesh_terms: D000328:Adult; D000368:Aged; D002248:Carbon Monoxide / Q000032:analysis*; D066300:Electronic Nicotine Delivery Systems / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012907:Smoking / Q000453:epidemiology; D016540:Smoking Cessation / Q000379:methods*; D000074606:Smoking Prevention; D011795:Surveys and Questionnaires
chemical_list: D002248:Carbon Monoxide