Rauchstopp-Hilfen im Vergleich: Medikamente, E-Zigarette, App – was wirklich wirkt

Tobacco use remains one of the leading preventable causes of morbidity and mortality worldwide, contributing to more than 7 million deaths annually and imposing a substantial economic burden on healthcare systems and global productivity. The addictive properties of tobacco are primarily mediated by nicotine, which exerts its effects through neuronal nicotinic acetylcholine receptors (nAChRs) within brain reward circuits. Among these receptor subtypes, α4β2-containing nAChRs play a central role in nicotine dependence by regulating dopaminergic signaling associated with reinforcement, craving, withdrawal, and relapse. Repeated nicotine exposure induces neuroadaptive changes in receptor expression and neural circuitry, contributing to the chronic and relapsing nature of addiction. Advances in addiction neuroscience and receptor pharmacology have enhanced the understanding of nicotine-mediated signaling and facilitated the development of evidence-based smoking cessation therapies. Current treatment approaches include nicotine replacement therapies, antidepressant-based interventions, and partial nAChR agonists such as varenicline and cytisine. Emerging strategies encompass subtype-selective ligands, allosteric modulators, immunotherapeutics, neuromodulation techniques, and digital health technologies aimed at improving cessation outcomes. This review summarizes the neuropharmacological mechanisms underlying nicotine addiction and critically examines current and emerging therapeut

<h4>Background and aims</h4>Electronic cigarettes (EC) are considered a smoking cessation tool in some countries, such as the United Kingdom, but uncertainty remains internationally over whether their benefits outweigh potential harms when used for this purpose. This overview (1) synthesised existing evidence from systematic reviews (SR) on the effectiveness and safety of ECs to explore and address these uncertainties and disagreements and (2) mapped primary intervention studies to identify priorities for further research.<h4>Methods</h4>Overview of SRs published from 1 January 2015 and meeting the inclusion criteria of the Cochrane review of EC for smoking cessation. We searched seven databases to April 2024. We followed Cochrane screening and data extraction methods. We adapted Campbell Collaboration and 3ie methods for the Evidence and Gap Map (EGM). We assessed review quality using AMSTAR-2.<h4>Results</h4>We included 14 reviews of intervention studies (7 high quality; 7 low quality), with search dates from 2014 to 2023, in adult populations including the general population, people at risk of lung cancer, with comorbid health conditions and pregnant people. Eighteen studies were included across multiple reviews, some of which included multiple meta-analyses. Across 21 meta-analytic comparisons of nicotine EC versus other interventions, all reported point estimates favouring nicotine EC for smoking cessation, with relative risks/odds ratios typically in the range 1.17-1.67

<h4>Introduction</h4>A significant proportion of patients with chronic airway diseases continue to smoke even after the diagnosis. In addition, smoking cessation support continues to be a neglected issue in real-life settings by physicians for that patient group. Therefore, in our search for a solution to this issue, we conducted our study to evaluate the effect of arranging immediate appointments to smoking cessation outpatient clinics on smoking cessation success in patients with chronic airway disease.<h4>Methods</h4>This multicenter, randomized, parallel-arm prospective study (NCT05764343) was conducted in pulmonary outpatient clinics between November 2022 and June 2023. Current smoker patients aged ≥18 years diagnosed with COPD, asthma, or bronchiectasis for at least 6 months were included and sequentially randomized in a 1:1 ratio. Both arms received brief smoking cessation interventions, and the intervention arm had immediate access to a smoking cessation clinic appointment. In contrast, the control arm received a standard quitline appointment for routine service. The primary endpoint was the self-reported smoking cessation rate at 3 months, analyzed using an intentionto-treat approach.<h4>Results</h4>The study comprised 198 patients in the immediate appointment arm and 199 in the usual care arm. The quit rate was significantly higher in the immediate appointment arm (26.7%) than in the usual care arm (16.5%, p=0.014). Access to smoking cessation medication was 69.3% i

<h4>Objectives</h4>Smoking remains a major preventable cause of lung and cardiovascular disease. This randomised controlled trial evaluated EILA, a mobile application using artificial intelligence, for promoting smoking cessation among hospital workers.<h4>Methods</h4>A randomised controlled trial was conducted. Hospital workers (n=43) were recruited from a German university hospital from May 2022 to March 2023. Inclusion criteria comprised age ≥18, Fagerström score ≥3 or 10 cigarettes per day, ownership of a suitable smartphone, motivation to quit smoking and no addiction to other psychoactive substances. Participants were randomised by sealed envelopes to EILA intervention (n=25) or a wait-list control (n=18) receiving a primary care-style intervention, with crossover after 3 months. The primary outcome was the cessation rate. Secondary outcomes comprised nicotine dependence, mental health and cardiovascular risk, all measured using validated questionnaires.<h4>Results</h4>At the 6-month follow-up, the relative risk for continued smoking was reduced to 0.91 (n=51, 95% CI 0.7 to 1.2), and nicotine dependence, measured by the Fagerström Test, decreased significantly from 4.41±1.93 to 3.32±2.69 (n=19, p=0.014). PROCAM score for cardiovascular risk was reduced from 35.22±12.47 to 31.9±13.24 (n=36, p=0.008).<h4>Conclusion</h4>The digital health application EILA was linked to increased smoking cessation rates, although without achieving statistical significance. Nevertheless, the