电子烟能戒烟吗?电子烟未必能戒烟

商家在售卖电子烟时,会宣传电子烟可以戒烟,一些人选择电子烟也是因为如此;但也有不少人说,电子烟不能戒烟,不要交这个智商税。会不会省不了烟草税,还额外交了一笔智商税呢?
 
初看起来,电子烟和尼古丁代替品是相似的。
 
尼古丁代替品是一些戒烟用物品的总称,它们主要用于尼古丁替代治疗法(NRT)。香烟里的尼古丁是上瘾物质,戒烟时人会有戒断反应,人会感到难受,因此放弃戒烟。
 
 
尼古丁贴片是一种被证明有效的戒烟的工具。神探夏洛克里,卷福曾使用尼古丁贴片来提神,他的用法是当然是错误的
 
如果戒烟时利用尼古丁贴片,尼古丁口香糖或尼古丁喷雾剂等物品向血液中输送尼古丁,就可以缓解戒烟的戒断反应,提高戒烟的成功率。
 
1996年世界卫生组织(WHO)就正式向各国推荐尼古丁代替治疗法[1]。FDA也批准了至少4种合法的尼古丁代替品,用于辅助戒烟。
 
电子烟似乎也能起到这样的作用,实际上,WHO把电子烟叫做“电子尼古丁输送系统”,把它和其他尼古丁替代品一起考察。
 
不过,虽然电子烟和尼古丁替代品相似,但电子烟使用在行为上又和吸烟相似,所以不能简单认为电子烟就能帮助戒烟。
 
 
蓝色药丸还是红色药丸?电子烟是否有害的讨论应该是对比式的,不能忽略香烟危害性的背景因素。脱离背景,讨论电子烟是否“绝对无害”具有很大的误导性
 
关于电子烟是否能帮助戒烟,研究结果并不一致。
 
例如,2014年发表在JAMA上的一篇论文表示,通过对949名吸烟者隔期一年的两次网上调查的纵向分析,用电子烟的人戒烟成功率没有提高,香烟消耗量上也没有减少。不过同时论文作者也表示这个调查依赖于个人口头报告,对被调查者电子烟的使用量、频次、习惯都不够了解。
 
另一些研究则认为电子烟能够帮助吸烟者戒烟或者减少吸烟。
 
2016年的一份元分析研究显示,选择电子烟戒烟的人,比起没有选择电子烟戒烟的人,成功戒烟的概率高了28%。
 
一份近期发表在考克兰系统回顾数据库的研究,电子烟能帮助戒烟,其效果比安慰剂效应要好。
 
 
“三傻”索菲·特纳和男友外出被人拍到,她正在使用的电子烟叫做juul,一种美国流行的电子烟。juul的流行给美国卫生部门造成了困扰,因为大量中学生开始尝试电子烟
 
另一份2015年的元分析研究表明,用含尼古丁的烟液,比用不含尼古丁烟液,更有可能戒烟;这说明一定程度上电子烟确实能起到和传统尼古丁代替疗法的作用。这份研究甚至表明,电子烟比传统尼古丁代替疗法更成功,更容易让人戒烟(20%成功率VS10%成功率)。
 
2015年《中国临床医生杂志》上发表的《北京市人吸烟人群使用电子烟情况的调查》研究中,作者也表示,电子烟可以使吸烟者戒烟或减少吸烟量,47.1%的吸烟者表示吸烟减少了。
 
 
从2011年到2017年,英国的吸烟率整体下降,英国公共卫生部认为,电子烟功不可没
 
英国的情况比较乐观,2018年英国公共卫生部发布博客表示,至少在英国,电子烟可以帮助人戒烟。英国的290万的电子烟使用者,有超过一半的人完全戒烟,预计电子烟每年还会帮助2万人戒烟。随着电子烟推广,英国吸烟率逐年下降,达到历史最低的15.5%,在整个欧洲仅高于瑞典。
 
保守一点看,根据WHO在2014年的说法,现有的研究,不足以证明使用电子烟能帮助完全戒除抽烟的习惯,优先推荐已经证实有效的传统尼古丁疗法。
 
WHO还认为,虽不能完全戒掉,很多人还是两杆烟枪并用,但因为他们会少抽点香烟,所以电子烟还是可以推荐给吸烟的人。
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