Die E-Zigarette – Mittel zur Tabakentwöhnung?

 

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Zusammenfassung

Tabakentwöhnung in Deutschland Nachdem der Tabakkonsum über mehrere Jahre rückläufig war, zeigt sich aktuell eine Stagnation bzw. ein Wiederanstieg der Rauchenden in Deutschland. Die Ursachen erscheinen vielfältig, wie z. B. Belastungen durch die Pandemie mit der sozialen Isolation, steigende Lebenshaltungskosten und Krieg in Europa. Bei einem weiterhin stark verbreiteten Tabakkonsum in der deutschen Bevölkerung wird eine evidenzbasierte Tabakentwöhnung nur selten durchgeführt.

Gesundheitsrisiken der E-Zigarette Nach neueren Studien sind E-Zigaretten an der Pathogenese von Lungenerkrankungen, Herz- und Gefäßschädigungen beteiligt. Zudem wirken ihre Inhaltsstoffe auch karzinogen. Klinische Untersuchungen zum dauerhaften Konsum liegen aber bisher nicht vor.

Wie wirksam ist die E-Zigarette bei der Tabakentwöhnung? E-Zigaretten als Konsumentenprodukt sind den in Leitlinien empfohlenen Nikotin-Ersatzpräparaten und suchthemmenden Medikamenten nicht überlegen. Im therapeutischen Setting sind sie etwas besser wirksam als Nikotin-Ersatzpräparate. Sie werden aber meistens dauerhaft konsumiert und verstetigen so die Nikotinabhängigkeit. Ihr Konsum erhöht die Rückfallgefahr zum Tabakrauchen.

Evidenzbasierte Tabakentwöhnung ambulant und stationär Trotz der verschiedenen neuen Ansätze, wie Internet-basierte Angebote, App etc., sind Gespräche und Pharmakotherapie der Goldstandard und wirksamer als jede Therapie für sich allein.

Abstract

After several years of declining tobacco consumption, the number of smokers in Germany is currently stagnating or rising again. The reasons seem to be manifold, e. g. stress caused by the pandemic with social isolation, rising cost of living and war in Europe.

With tobacco use still widespread in the German population, evidence-based tobacco cessation is rarely implemented.

According to recent studies, e-cigarettes are involved in the pathogenesis of lung disease, cardiac and vascular damage. In addition, their ingredients also have carcinogenic effects. However, clinical studies on long-term use are not yet available.

E-cigarettes as a consumer product are not superior to nicotine replacement products and addiction-reducing medications recommended in guidelines. In the therapeutic setting, they are slightly more effective than nicotine replacement products. However, they are usually consumed continuously and thus perpetuate nicotine dependence. Their use increases the risk of relapse to tobacco smoking.

Despite the various new approaches, such as Internet-based offerings, app, etc., talks and pharmacotherapy are the gold standard and more effective than any therapy on its own.

Publication History

Article published online:
21 November 2023

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