{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T22:50:22Z","timestamp":1767135022066,"version":"build-2238731810"},"reference-count":27,"publisher":"American Medical Association (AMA)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Intern Med"],"published-print":{"date-parts":[[2024,3,1]]},"abstract":"\n Importance<\/jats:title>\n Electronic cigarettes (ECs) are often used by smokers as an aid to stopping smoking, but evidence is limited regarding their efficacy compared with nicotine replacement therapy (NRT), and no evidence is available on how their efficacy compares with that of varenicline.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To evaluate whether ECs are superior to NRT and noninferior to varenicline in helping smokers quit.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This was a randomized clinical trial conducted at 7 sites in China and including participants who were smoking at least 10 cigarettes per day and motivated to quit, not using stop-smoking medications or EC, and willing to use any of the study products. Participants were first recruited in May 2021, and data analysis was conducted in December 2022.<\/jats:p>\n <\/jats:sec>\n \n Interventions<\/jats:title>\n A cartridge-based EC (30 mg\/mL nicotine salt for 2 weeks and 50 mg\/mL after that), varenicline (0.5 mg, once a day for 3 days; 0.5 mg, twice a day for 4 days; and 1 mg, twice a day, after that), and 2 mg (for smokers of \u226420 cigarettes per day) or 4 mg (&amp;gt;20 cigarettes per day) nicotine chewing gum, all provided for 12 weeks and accompanied by minimal behavioral support (an invitation to join a self-help internet forum).<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n The primary outcome was sustained abstinence from smoking at 6 months as validated by an expired-air carbon monoxide reading (&amp;lt;8 parts per million). Participants lost to follow-up were included as nonabstainers.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Of 1068 participants, 357 (33.5%) were female, and the mean (SD) age was 33.9 (3.1) years. A total of 409 (38.3%), 409 (38.3%), and 250 (23.4%) participants were randomized to the EC, varenicline, and NRT arms, respectively. The 6-month biochemically validated abstinence rates were 15.7% (n\u2009=\u200964), 14.2% (n\u2009=\u200958), and 8.8% (n\u2009=\u200922) in the EC, varenicline, and NRT study arms, respectively. The quit rate in the EC arm was noninferior to the varenicline arm (absolute risk reduction, 1.47%; 95% CI, \u22121.41% to 4.34%) and higher than in the NRT arm (odds ratio, 1.92; 95% CI, 1.15-3.21). Treatment adherence was similar in all study arms during the initial 3 months, but 257 participants (62.8%) in the EC arm were still using ECs at 6 months, with no further use in the 2 other study arms. The most common adverse reactions were throat irritation (32 [7.8%]) and mouth irritation (28 [6.9%]) in the EC arm, nausea (36 [8.8%]) in the varenicline arm, and throat irritation (20 [8.0%]) and mouth irritation (22 [8.8%]) in the NRT arm. No serious adverse events were recorded.<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n The results of this randomized clinical trial found that when all treatments were provided with minimal behavior support, the efficacy of EC was noninferior to varenicline and superior to nicotine chewing gum.<\/jats:p>\n <\/jats:sec>\n \n Trial Registration<\/jats:title>\n \n Chinese Clinical Trial Registry:\n ChiCTR2100048156<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamainternmed.2023.7846","type":"journal-article","created":{"date-parts":[[2024,1,29]],"date-time":"2024-01-29T12:32:18Z","timestamp":1706531538000},"page":"291","source":"Crossref","is-referenced-by-count":8,"title":["RETRACTED: Efficacy of Electronic Cigarettes vs Varenicline and Nicotine Chewing Gum as an Aid to Stop Smoking"],"prefix":"10.1001","volume":"184","author":[{"given":"Hao-Xiang","family":"Lin","sequence":"first","affiliation":[{"name":"Institute for Global Health and Development, Peking University, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhao","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Tobacco Control and Prevention of Respiratory Disease, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Hajek","sequence":"additional","affiliation":[{"name":"Wolfson Institute of Population Health, Queen Mary University of London, London, England"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wan-Tong","family":"Zhang","sequence":"additional","affiliation":[{"name":"Institute of Clinical Pharmacology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuan","family":"Wu","sequence":"additional","affiliation":[{"name":"China Academy of Chinese Medical Sciences, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bao-Chen","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hai-Hua","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Traditional Chinese Medicine, Beijing Geriatric Hospital, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qiu","family":"Xiang","sequence":"additional","affiliation":[{"name":"Respiratory Intensive Care Unit, Tongji Hospital Affiliated with Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Office of China Journal of Traditional Chinese Medicine and Pharmacy, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shu-Bin","family":"Li","sequence":"additional","affiliation":[{"name":"Beijing PL Technology Co, Ltd, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesca","family":"Pesola","sequence":"additional","affiliation":[{"name":"Wolfson Institute of Population Health, Queen Mary University of London, London, England"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ying-Ying","family":"Wang","sequence":"additional","affiliation":[{"name":"Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10","reference":[{"issue":"9","key":"ioi230095r1","doi-asserted-by":"publisher","first-page":"1661","DOI":"10.2105\/AJPH.2021.306416","article-title":"Balancing consideration of the risks and benefits of e-cigarettes.","volume":"111","author":"Balfour","year":"2021","journal-title":"Am J Public Health"},{"issue":"3","key":"ioi230095r2","doi-asserted-by":"publisher","first-page":"520","DOI":"10.1038\/s41591-022-02201-7","article-title":"Nicotine e-cigarettes as a tool for smoking cessation.","volume":"29","author":"Warner","year":"2023","journal-title":"Nat Med"},{"key":"ioi230095r3","doi-asserted-by":"publisher","DOI":"10.5888\/pcd14.160600","article-title":"Quit methods used by US adult cigarette smokers, 2014-2016.","volume":"14","author":"Caraballo","year":"2017","journal-title":"Prev Chronic Dis"},{"issue":"11","key":"ioi230095r5","article-title":"Electronic cigarettes for smoking cessation.","volume":"11","author":"Hartmann-Boyce","year":"2022","journal-title":"Cochrane Database Syst Rev"},{"issue":"5","key":"ioi230095r6","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD006103.pub7","article-title":"Nicotine receptor partial agonists for smoking cessation.","volume":"2016","author":"Cahill","year":"2016","journal-title":"Cochrane Database Syst Rev"},{"issue":"3","key":"ioi230095r7","doi-asserted-by":"publisher","first-page":"395","DOI":"10.1093\/ntr\/ntac149","article-title":"E-cigarettes to augment stop smoking in-person support and treatment with varenicline (E-ASSIST): a pragmatic randomized controlled trial.","volume":"25","author":"Tattan-Birch","year":"2023","journal-title":"Nicotine Tob Res"},{"issue":"7","key":"ioi230095r8","doi-asserted-by":"publisher","first-page":"429","DOI":"10.7326\/M17-3440","article-title":"Prevalence and distribution of e-cigarette use among U.S. adults: behavioral risk factor surveillance system, 2016.","volume":"169","author":"Mirbolouk","year":"2018","journal-title":"Ann Intern Med"},{"issue":"12","key":"ioi230095r9","doi-asserted-by":"publisher","first-page":"1010","DOI":"10.1016\/S2213-2600(19)30399-6","article-title":"E-cigarette use in Great Britain.","volume":"7","author":"Kirby","year":"2019","journal-title":"Lancet Respir Med"},{"issue":"12","key":"ioi230095r12","doi-asserted-by":"publisher","first-page":"e639","DOI":"10.1016\/S2468-2667(20)30145-6","article-title":"E-cigarette use among adults in China: findings from repeated cross-sectional surveys in 2015-16 and 2018-19.","volume":"5","author":"Zhao","year":"2020","journal-title":"Lancet Public Health"},{"issue":"5","key":"ioi230095r13","doi-asserted-by":"publisher","first-page":"958","DOI":"10.1038\/s41591-022-01808-0","article-title":"Electronic cigarettes versus nicotine patches for smoking cessation in pregnancy: a randomized controlled trial.","volume":"28","author":"Hajek","year":"2022","journal-title":"Nat Med"},{"issue":"1","key":"ioi230095r15","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1093\/ntr\/ntr137","article-title":"Determinants of tobacco use and renaming the FTND to the Fagerstrom test for cigarette dependence.","volume":"14","author":"Fagerstr\u00f6m","year":"2012","journal-title":"Nicotine Tob Res"},{"key":"ioi230095r16","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1186\/1477-7525-1-29","article-title":"The hospital anxiety and depression scale.","volume":"1","author":"Snaith","year":"2003","journal-title":"Health Qual Life Outcomes"},{"issue":"3","key":"ioi230095r17","doi-asserted-by":"publisher","first-page":"648","DOI":"10.1183\/09031936.00102509","article-title":"Development and first validation of the COPD assessment test.","volume":"34","author":"Jones","year":"2009","journal-title":"Eur Respir J"},{"issue":"3","key":"ioi230095r18","doi-asserted-by":"publisher","first-page":"289","DOI":"10.1001\/archpsyc.1986.01800030107013","article-title":"Signs and symptoms of tobacco withdrawal.","volume":"43","author":"Hughes","year":"1986","journal-title":"Arch Gen Psychiatry"},{"issue":"3","key":"ioi230095r19","doi-asserted-by":"publisher","first-page":"299","DOI":"10.1111\/add.2005.100.issue-3","article-title":"Outcome criteria in smoking cessation trials: proposal for a common standard.","volume":"100","author":"West","year":"2005","journal-title":"Addiction"},{"key":"ioi230095r20","doi-asserted-by":"publisher","first-page":"1203","DOI":"10.2147\/COPD.S301579","article-title":"Adherence and efficacy of smoking cessation treatment among patients with COPD in China.","volume":"16","author":"Qin","year":"2021","journal-title":"Int J Chron Obstruct Pulmon Dis"},{"issue":"4","key":"ioi230095r21","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD013308","article-title":"Different doses, durations and modes of delivery of nicotine replacement therapy for smoking cessation.","volume":"4","author":"Lindson","year":"2019","journal-title":"Cochrane Database Syst Rev"},{"issue":"7","key":"ioi230095r22","doi-asserted-by":"publisher","first-page":"629","DOI":"10.1056\/NEJMoa1808779","article-title":"A randomized trial of e-cigarettes versus nicotine-replacement therapy.","volume":"380","author":"Hajek","year":"2019","journal-title":"N Engl J Med"},{"issue":"6","key":"ioi230095r23","article-title":"Different doses, durations and modes of delivery of nicotine replacement therapy for smoking cessation.","volume":"6","author":"Theodoulou","year":"2023","journal-title":"Cochrane Database Syst Rev"},{"issue":"10037","key":"ioi230095r24","doi-asserted-by":"publisher","first-page":"2507","DOI":"10.1016\/S0140-6736(16)30272-0","article-title":"Neuropsychiatric safety and efficacy of varenicline, bupropion, and nicotine patch in smokers with and without psychiatric disorders (EAGLES): a double-blind, randomised, placebo-controlled clinical trial.","volume":"387","author":"Anthenelli","year":"2016","journal-title":"Lancet"},{"issue":"1","key":"ioi230095r25","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.01815-2019","article-title":"E-cigarette use and respiratory disorders: an integrative review of converging evidence from epidemiological and laboratory studies.","volume":"57","author":"Wills","year":"2021","journal-title":"Eur Respir J"},{"key":"ioi230095r10","volume-title":"China Adult Tobacco Survey 2015 Report","author":"Liang","year":"2016"},{"key":"ioi230095r11","volume-title":"China Adult Tobacco Survey 2018 Report","author":"Li","year":"2020"},{"key":"ioi230095r14","volume-title":"China Clinical Guidelines for Tobacco Cessation (2015 Version)","author":"China National Health and Family Planning Commission","year":"2015"},{"key":"ioi230095r26","volume-title":"China\u2019s Report on the Health Hazards of Smoking 2020","author":"China Health Commission","year":"2021"},{"key":"ioi230095r4","unstructured":"McNeillA, BroseL, RobsonD, . Nicotine vaping in England: an evidence update including health risks and perceptions. Accessed March 8, 2023. https:\/\/www.gov.uk\/government\/publications\/nicotine-vaping-in-england-2022-evidence-update"},{"key":"ioi230095r27","unstructured":"US Food and Drug Administration. Pfizer expands voluntary nationwide recall to include all lots of Chantix (varenicline) tablets due to N-nitroso varenicline content. Accessed December 20, 2023. https:\/\/www.fda.gov\/safety\/recalls-market-withdrawals-safety-alerts\/pfizer-expands-voluntary-nationwide-recall-include-all-lots-chantixr-varenicline-tablets-due-n"}],"updated-by":[{"DOI":"10.1001\/jamainternmed.2024.1125","type":"retraction","label":"Retraction","source":"retraction-watch","updated":{"date-parts":[[2024,3,29]],"date-time":"2024-03-29T00:00:00Z","timestamp":1711670400000},"record-id":"52992"}],"container-title":["JAMA Internal Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamainternalmedicine\/articlepdf\/2814489\/jamainternal_lin_2024_oi_230095_13941_1711468389.7923.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,3,29]],"date-time":"2024-03-29T11:00:35Z","timestamp":1711710035000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamainternalmedicine\/fullarticle\/2814489"}},"subtitle":["A Randomized Clinical Trial"],"short-title":[],"issued":{"date-parts":[[2024,3,1]]},"references-count":27,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2024,3,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamainternmed.2023.7846","relation":{},"ISSN":["2168-6106"],"issn-type":[{"value":"2168-6106","type":"print"}],"subject":[],"published":{"date-parts":[[2024,3,1]]}}}