Evidence map›Paper›PMID 33503247›Full record

SynthesisNicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco2021

Health Risks of Kretek Cigarettes: A Systematic Review.

Desy Nuryunarsih, Sarah Lewis, Tessa Langley

Open access · hybridAbstract readSystematic Review
In one paragraph

Synthesis in Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
4.0field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 13 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors at 1 institution in 1 country.

Desy NuryunarsihDivision of Epidemiology and Public Health, University of Nottingham, Nottingham, UK.
Sarah LewisDivision of Epidemiology and Public Health, University of Nottingham, Nottingham, UK.
Tessa LangleyDivision of Epidemiology and Public Health, University of Nottingham, Nottingham, UK.ORCID 0000-0001-9560-1148
University of Nottingham · GB

Funding

Medical Research Council MR/S037519/1
6 · The paper itself

Abstract

introductionThe objective of this study is review the evidence on the health risks associated with smoking kretek cigarettes compared with not smoking or smoking regular cigarettes.

methodsWe conducted a systematic literature search in five electronic databases: EMBASE (Ovid), ASSIA, PubMed and Scopus. Since kretek use is largely restricted to Indonesia, we identified additional studies using an online search for grey literature and studies in Indonesian journals and the National Library of Indonesia. We included relevant search terms in English ("kretek" and "clove cigarettes") and Bahasa ("rokok" and "merokok"). We selected studies which compared any health outcome between smokers of kretek cigarettes and non-smokers or smokers of regular cigarettes. We included studies in any smokers compared to non-smokers in Indonesia, since most Indonesian smokers use kretek, but analysed these separately. Study data were extracted by a single reviewer and checked by two reviewers. Methodological quality was assessed using the Newcastle-Ottawa scale.

resultsWe identified 32 studies, all from Indonesia. There were 31 cross-sectional studies and one case control study. This systematic review identified a relatively limited number of studies, and most of these were of poor quality as assessed by the Newcastle Ottawa score. They were generally cross-sectional, small and lacking justification for sample size, had high potential for selection bias because of lack of data on non-respondents or those lost to follow up, and missing information about the statistical analysis. Fourteen studies looked specifically at kretek exposure and eighteen looked at any type of cigarette exposure but were conducted in Indonesia are therefore likely to predominantly reflect kretek exposure. Kretek were found to be associated with oral cancer, cardiovascular disease, chronic health disease, myocardial infarction, asthma, and oral diseases.

conclusionsAlthough existing studies are of poor quality, kretek are likely to be at least as harmful as regular cigarettes.

Indexed as

Tobacco ProductsCase-Control StudiesCross-Sectional StudiesHumansSmokeSmokingSmoke

Identifiers

PMID33503247
PMCPMC8360627
OpenAlexW3123167942

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.