ArticleMedicine2021
An association between electronic nicotine delivery systems use and a history of stroke using the 2016 behavioral risk factor surveillance system.
Article in Medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 4 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
17 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Electronic cigarettes and cardiovascular outcomes: a systematic review and meta-analysis of Major Adverse Cardiovascular Events (MACE).BMC public health · 2026Pooled it
- Are electronic cigarettes associated with the risk of myocardial infarction and stroke? A systematic review and meta-analysis.BMC public health · 2025Pooled it
- Population-Based Disease Odds for E-Cigarettes and Dual Use versus Cigarettes.NEJM evidence · 2024Pooled it
- Comparison of e-Cigarette and Cigarette Use and Dual Use Associations With Disease: Updated Systematic Review and Meta-Analysis.Public health reports (Washington, D.C. : 1974)Pooled it
- A Narrative Review of the Potential Impact of Next-Generation Tobacco and Nicotine Products on Cardiovascular Health.Cureus · 2026Review
- Multisystem Toxicity of E-Cigarettes in Preclinical and Clinical Studies: Pathophysiologic Effects of E-Cigarette Aerosol Exposures from Head to Toe.Annual review of pharmacology and toxicology · 2026Review
- Inaccurate and misleading meta-analysis of E-cigarettes and population-based diseases.Internal and emergency medicine · 2025Article
- Comparing smoking-related disease rates from e-cigarette use with those from tobacco cigarette use: a reanalysis of a recently-published study.Harm reduction journal · 2025Article
- Observational studies of exposure to tobacco and nicotine products: Best practices for maximizing statistical precision and accuracy.iScience · 2025Review
- Adult Electronic Nicotine Delivery System Use in the USA: a Scoping Review Through a Health Equity Lens.Current addiction reports · 2023Article
- Sex Differences in E-Cigarette Use and Related Health Effects.International journal of environmental research and public health · 2023Review
- The association between combustible/electronic cigarette use and stroke based on national health and nutrition examination survey.BMC public health · 2023Article
- Association between electronic nicotine delivery systems use and risk of stroke: a meta-analysis of 1,024,401 participants.Archives of medical science : AMS · 2023Article
- Chronic E-Cigarette Use Impairs Endothelial Function on the Physiological and Cellular Levels.Arteriosclerosis, thrombosis, and vascular biology · 2022Article
- Prevalence of Cerebrovascular Accidents Among the US Population With Substance Use Disorders: A Nationwide Study.Cureus · 2022Article
- Is electronic cigarette use a risk factor for stroke? A systematic review and meta-analysis.Tobacco induced diseases · 2022Review
- How Electronic Cigarette Affects the Vascular System.Journal of smoking cessation · 2022Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
abstractElectronic nicotine delivery systems (ENDS) are growing in use and many of the health implications with these devices remain unknown. This study aims to assess, using a survey representative of the USA general population, if an association exists between a history of ENDS use and a history of stroke.This cross-sectional study was a secondary data analysis using the 2016 behavioral risk factor surveillance system survey. The main exposure variable of the study was a self-reported history of ENDS use. The main outcome was a self-reported history of stroke. Covariates included sex, race, traditional cigarette use, smokeless tobacco use, chronic kidney disease, diabetes, myocardial infarction, and coronary artery disease. Unadjusted and adjusted logistic regression analyses were done. Adjusted odds ratios (AOR) and their corresponding 95% confidence intervals (CI) were calculated.Of the 486,303 total behavioral risk factor surveillance system survey participants, 465,594 met the inclusion criteria for this study of ENDS use and stroke. This study shows that current ENDS use was positively associated with a history of stroke. AOR of some daily ENDS use with stroke was 1.28 (95% CI: 1.02-1.61) and AOR of current daily ENDS use with stroke was 1.62 (95% CI: 1.18-2.31). The majority (55.9%) of current daily ENDS users reported former traditional cigarette smoking. Female sex, non-white ethnicity, elderly age, chronic kidney disease, coronary artery disease, diabetes, and traditional cigarette use characteristics were all also associated with increased odds of reporting a stroke.This study found a statistically significant and positive association between ENDS use and a history of stroke. Further research is warranted to investigate the reproducibility and temporality of this association. Nevertheless, this study contributes to the growing body of knowledge about the potential cardiovascular concerns related to ENDS use and the need for large cohort studies.
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.