SynthesisBMJ open2021
E-cigarette use and combustible tobacco cigarette smoking uptake among non-smokers, including relapse in former smokers: umbrella review, systematic review and meta-analysis.
Synthesis in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 69 papers, 10 of them syntheses that pooled 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.
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.
Who cites it
69 citing papers in PubMed, 10 syntheses or guidelines pooled it, 124 citations in OpenAlex.
- Vaping and Smoking in Pregnancy-A Meta-Analysis of Neurobehavioural Development in Prenatally Exposed Offspring.Acta paediatrica (Oslo, Norway : 1992) · 2025Pooled it
- Health impacts of electronic nicotine delivery systems: an umbrella review of systematic reviews.BMJ open · 2025Pooled it
- Guideline
- Recommendations on interventions for tobacco smoking cessation in adults in Canada.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2025Guideline
- Thoracic Society of Australia and New Zealand (TSANZ) Guidance for the Management of Electronic Cigarette Use (Vaping) in Adolescents and Adults.Respirology (Carlton, Vic.) · 2025Guideline
- Association of electronic cigarette use and suicidal behaviors: a systematic review and meta-analysis.BMC psychiatry · 2024Pooled it
- A systematic review and meta-analysis of the association between e-cigarette use among non-tobacco users and initiating smoking of combustible cigarettes.Harm reduction journal · 2024Pooled it
- Electronic cigarettes and health outcomes: umbrella and systematic review of the global evidence.The Medical journal of Australia · 2023Pooled it
- E-cigarettes and nicotine abstinence: a meta-analysis of randomised controlled trials.European respiratory review : an official journal of the European Respiratory Society · 2022Pooled it
- Pooled it
- Adolescent behavioural intentions: Secondary outcomes from a cluster randomized controlled trial of the Health4Life school-based lifestyle modification intervention.Canadian journal of public health = Revue canadienne de sante publique · 2025Trial
- Article
- Electronic cigarette use, related health outcomes and policy interventions in the USA: a call for research to fill evidence gaps.Tobacco control · 2026Review
- New versus continued e-cigarette use and cigarette reuptake among US adults who formerly smoked cigarettes.Addictive behaviors · 2026Article
- Vaping Education in Australian High Schools: A Quality Improvement Project.The Journal of school nursing : the official publication of the National Association of School Nurses · 2026Article
- To Vape or Not to Vape: Oral Health in the Age of Electronic Nicotine Delivery Systems and Electronic Non-Nicotine Delivery Systems.International dental journal · 2026Review
- Interactions Between e-Cigarette Use and Quit Intentions on Cigarette Smoking in Lesbian, Gay, Bisexual, Transgender, Queer, and Other Non-Heterosexual or Cisgender Individuals.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2026Article
- Demographic trends and mortality disparities in emphysema across the United States (1999-2023): a retrospective population-based study using CDC WONDER database.Annals of medicine and surgery (2012) · 2026Article
- Perception of e-cigarette as a harmful product delays initiation by two years among Mexican students aged 14-29 years.BMC pulmonary medicine · 2026Observational
- Quit journey lessons: qualitative insights from men in Qatar who formerly vaped.BMC public health · 2026Article
9 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo review and summarise the current evidence on the uptake of combustible cigarette smoking following e-cigarette use in non-smokers-including never-smokers, people not currently smoking and past smokers-through an umbrella review, systematic review and meta-analysis.
designUmbrella review, systematic review and meta-analysis. DATA SOURCES: PubMed, Scopus, Web of Science, PsychINFO (Ovid), Medline (Ovid) and Wiley Cochrane Library up to April 2020.
resultsOf 6225 results, 25 studies of non-smokers-never, not current and former smokers-with a baseline measure of e-cigarette use and an outcome measure of combustible smoking uptake were included. All 25 studies found increased risk of smoking uptake with e-cigarette exposure, although magnitude varied substantially. Using a random-effects model, comparing e-cigarette users versus non-e-cigarette users, among never-smokers at baseline the OR for smoking initiation was 3.25 (95% CI 2.61 to 4.05, I
conclusionsAcross multiple settings, non-smokers who use e-cigarettes are consistently more likely than those avoiding e-cigarettes to initiate combustible cigarette smoking and become current smokers. The magnitude of this risk varied, with an average of around three times the odds. Former smokers using e-cigarettes have over twice the odds of relapse as non-e-cigarettes users. This study is the first to our knowledge to review and pool data on the latter topic. PROSPERO REGISTRATION NUMBER: CRD42020168596.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.