Heated tobacco products and a telemedicine smoking cessation programme: A retrospective study (preprint)

ABSTRACT Objectives Japan is one of the largest markets for heated tobacco products (HTP), and the number of HTP users, including dual users, is burgeoning. However, it is not yet clear whether a telemedicine smoking cessation programme is helpful for nicotine-dependent people who use HTPs. Methods We retrospectively evaluated the effectiveness of a telemedicine smoking cessation programme for nicotine-dependent tobacco product users, comparing short- and long-term continuous abstinence rates (CAR) from 9 to 24 weeks (CAR9-24) and 9 to 52 weeks (CAR9-52). We divided programme participants into 1) exclusively cigarette users, 2) exclusively HTP users, and 3) dual users. Using logistic regression with inverse probability weighting, an adjusted odds ratio (aOR) with a 95% confidence interval (CI) for CAR was calculated to compare the differences among the three groups. Results We analysed 733 telemedicine smoking cessation programme participants (exclusively cigarette users, 52%; exclusively HTP users, 31%; and dual-users, 16%) dating August 2018 to October 2020. HTP users had higher CARs than the exclusively cigarettes group in CAR9-24 (aOR, 1.12; CI, 1.02–1.23; p=0.02) and CAR9-52 (aOR 1.09; CI, 0.99–1.19; p=0.08). Conversely, dual users had lower CARs than the exclusively cigarettes group in the CAR9-24 (aOR, 0.85; CI, 0.76–0.95; p=0.004) and CAR9-52 (aOR, 0.88; CI, 0.79–0.97; p=0.01). Conclusions Exclusively HTP users achieved higher CARs, whereas dual users had lower CARs than exclusively cigarette users over short- and long-term periods. A telemedicine smoking cessation programme may be a reasonable option for exclusively HTP users. Key messages What is already known on this topic Telemedicine smoking cessation programmes can be helpful for some nicotine-dependent people. What this study adds Exclusively HTP users had higher continuous abstinence rates (CARs) than the exclusively cigarettes group. Conversely, dual users had lower CARs than the exclusively cigarettes group. A telemedicine smoking cessation programme may be a reasonable option for exclusive HTP users. How this study might affect research, practice, or policy In addition to conventional combustible cigarettes, the number of HTP users, including dual users, is burgeoning in Japan. This study could add an effective and alternative option for HTP users to remotely quit smoking in the era of COVID-19 and beyond.

Early Detection of Exacerbation of the Severe Acute Respiratory Syndrome Coronavirus 2 Infection using Fitbit (DEXTERITY Pilot Study) (preprint)

Some patients with coronavirus disease 2019 (COVID-19) experienced sudden death because of sudden symptom deterioration. Thus, an alarm system that could detect early signs of COVID-19 exacerbation beforehand, to prevent serious illness or death of patients while receiving outpatient treatment at home or in hotels is necessary. Here, we tested whether estimated oxygen variations (EOV), a relative physiological scale that represents users’ blood oxygen saturation level during sleep measured by Fitbit, predicted COVID-19 symptom exacerbation. Study period was from August to November 2020. We enrolled 23 COVID-19 patients diagnosed by SARS-CoV-2 polymerase chain reaction-positive (mean age ± standard deviation, 50.9 ± 20 years; 70% female), let each patient wore the Fitbit for 30 days; COVID-19 symptoms were exacerbated in 6 (26%). High EOV signal (a patient’s oxygen level exhibits significant dip and recovery within the index period) had 80% sensitivity before symptom exacerbations, whereas resting heart rate signal only had 50% sensitivity. Coincidental obstructive sleep apnea syndrome confirmed by polysomnography was detected in a patient by consistently high EOV signals. This pilot study successfully detected early COVID-19 symptoms exacerbation by measuring EOV and may help to identify early signs of COVID-19 exacerbation.