Title	Electronic Cigarettes Are an Effective Cessation Reduction Tool for Dental Patients Who Smoke
Clinical Question	Do electronic cigarettes reduce cigarette consumption in dental patients who smoke cigarettes?
Clinical Bottom Line	E-cigarettes (with or without nicotine) can be a modestly effective tool to reduce harm in dental patients who smoke by decreasing consumption and promoting complete abstinence without causing significant side effects.
Best Evidence
PubMed ID Author / Year Patient Group Study type (level of evidence) 23826093 Caponnetto/2013 300 pts divided into 3 groups of 100: Group A (7.2 mg nicotine cartridges for 12 wks), Group B (A (7.2 mg nicotine cartridges for 6 wks), Group C (no nicotine cartridges for 12 wks). Randomized Controlled Trial Key results Results indicated a reduction of cigarette consumption by 22.3% at week 12, and 10.3% at week 52. Adverse side effects such as frequent coughing, dry mouth, throat irritation, headaches, and shortness of breath reduced from baseline. The most significant reduction was observed with shortness of breath side effect from 20 to 4% by week 2. There were no significant findings regarding changes for mean blood pressure, resting heart rate, and weight from the baseline. In all three groups, smokers reduced the amount of cigarettes consumption per day from baseline along with reduction in carbon monoxide levels exhaled by more than 50% (p<0.001 vs. baseline). The mean quit rates were 10.7% at week 12 and 8.7% at week 52.
Evidence Search	("Smoking"[Mesh]) AND "Smoking Cessation"[Mesh]) AND "Electronics"[Mesh]
Comments on The Evidence	Quality of the evidence meets the gold standards of a double-blinded, controlled, randomized clinical study. According to Caponnetto et.al, subjects who did not complete the study did not affect results because they “were not significantly different from participants who did complete the study.” The timeline of the study was appropriate with a baseline evaluation at the first visit, followed by six-intervention phase visits spaced out every two weeks, and two-observation phase follow up visits at 24 weeks and 52 weeks. The study could improve by adding another group to the study (Group D: non e-cigarette smokers) and as a comparison to smokers who do not utilize e-cigarettes. Although e-cigarettes are controversial, the authors acknowledge that this ECLAT study model details the smoking habits of 300 smokers with no intention of quitting and no biased results to report.
Applicability	This information is applicable to patients who smoke and have questions regarding the use of electronic cigarettes. Electronic cigarettes can be a supportive option for dental practitioners administrating tobacco cessation counseling for their patients who smoke.
Specialty	(Public Health) (General Dentistry) (Periodontics) (Dental Hygiene) (Behavioral Science)
Keywords	Electronic cigarettes, smoking cessation, smoking, nicotine, electronic interventions
ID#	2720
Date of submission	03/26/2014
E-mail	tamia@livemail.uthscsa.edu
Author	Alexandria Tami
Co-author(s)
Co-author(s) e-mail
Faculty mentor	Moshtagh R. Farokhi, DDS, MPH
Faculty mentor e-mail	farokhi@uthscsa.edu
Basic Science Rationale (Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?) None available
Comments and Evidence-Based Updates on the CAT (FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs) None available